Raphael Eva, Argante Lorenzo, Cinconze Elisa, Nannizzi Sara, Belmont Cheyenne, Mastrangelo Claire F, Allegretti Yuan Hu, Pellegrini Michele, Schmidt Johannes E
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Department of Family and Community Medicine, University of California, San Francisco, CA, USA.
Res Rep Urol. 2024 Oct 9;16:253-264. doi: 10.2147/RRU.S470605. eCollection 2024.
Urinary tract infections (UTIs) are among the most common bacterial infections, with uropathogenic (UPEC) as the main etiologic agent of uncomplicated UTIs (uUTIs). The prevalence of uUTis caused by organisms with antimicrobial resistance (AMR) is increasing worldwide, complexifying the disease management and increasing the risk of complications. In efforts to develop new strategies for uUTI prevention, it is imperative to understand factors associated with the occurrence of new episodes.
This retrospective cohort study aimed to assess the incidence of uUTIs caused by UPEC (UPEC-uUTIs) or unknown etiology (untested uUTIs) in adults aged ≥18 years receiving care in a San Francisco healthcare system.
During 2014-2019, 1087 UPEC-uUTI and 4106 untested uUTI cases were documented, of which 324 (29.8%; 95% confidence interval: 27.1%-32.6%) and 1030 (25.1%; 95% confidence interval: 23.8%-26.4%) were followed by ≥1 new episode of uUTI within 12 months. In the UPEC-uUTI cohort, male gender, diagnosis of diabetes mellitus, and prior uUTI were risk factors for new episodes of uUTI. At the time of first UPEC-uUTI diagnosis, antimicrobial prescriptions were retrieved for 41.1% of cases. When tested, AMR was most frequently reported for trimethoprim/sulfamethoxazole or trimethoprim/sulfamethoxazole prescribed with other antimicrobials.
Our study provides important information on the incidence and risk of repeated episodes of uUTIs, as well as on AMR related to them.
尿路感染（UTIs）是最常见的细菌感染之一，尿路致病性大肠埃希菌（UPEC）是单纯性尿路感染（uUTIs）的主要病原体。由具有抗菌药物耐药性（AMR）的病原体引起的uUTIs在全球范围内的患病率正在上升，这使疾病管理变得复杂，并增加了并发症的风险。为努力制定预防uUTI的新策略，了解与新发病例发生相关的因素至关重要。
这项回顾性队列研究旨在评估在旧金山医疗系统接受治疗的≥18岁成年人中由UPEC引起的uUTIs（UPEC-uUTIs）或病因不明的uUTIs（未经检测的uUTIs）的发病率。
在2014年至2019年期间，记录了1087例UPEC-uUTI病例和4106例未经检测的uUTI病例，其中分别有324例（29.8%；95%置信区间：27.1%-32.6%）和1030例（25.1%；95%置信区间：23.8%-26.4%）在12个月内出现≥1次新的uUTI发作。在UPEC-uUTI队列中，男性、糖尿病诊断和既往uUTI是uUTI新发作的危险因素。在首次诊断UPEC-uUTI时，41.1%的病例检索到了抗菌药物处方。检测时，对甲氧苄啶/磺胺甲恶唑或与其他抗菌药物联用的甲氧苄啶/磺胺甲恶唑的AMR报告最为频繁。
我们的研究提供了关于uUTIs复发的发病率和风险以及与之相关的AMR的重要信息。
