Global prevalence and etiologies of urinary tract infection among oncologic patients: a systematic review and meta-analysis.

BACKGROUND

Chemotherapy can lead to severe and prolonged immunosuppression, which puts oncologic patients at a higher risk of UTIs. This review determined the global prevalence and etiologic agents of UTIs among oncologic patients.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for reporting. The article search was performed via PubMed, Medline, EMBASE, Google Scholar, Hinari, Web of Science, Science Direct, and African Journals Online. Data were extracted via a Microsoft Excel spreadsheet and analyzed via STATA version 11.0. A random effects model was used to estimate the pooled effect size across the studies. The heterogeneity was checked via the I statistic. The publication bias was determined via a funnel plot and Egger's test, with a p-value < 0.05 indicating statistically significant bias. Subgroup and sensitivity analyses were subsequently performed.

RESULTS

Eighteen articles were eligible for this review. The pooled estimate of UTI incidence was 34.39% (95% CI: 22.29-46.49), with high heterogeneity (I = 96.2%) and statistical significance (p < 0.001). In the subgroup analysis, a high prevalence of UTIs was observed in Asia (49.71%), with studies not reporting the type of malignancy (68.87%; 95% CI: 59.95-77.79%), symptomatic bacteriuria (34.86%), and adults (39.87%). Among the etiologic agents of UTI, the most common was E. coli (19.99%, 95% CI: 10.27-29.71%), followed by Klebsiella spp. (5.12%, 95% CI: 2.47-7.76%). The pooled prevalence of UTIs among patients with bladder cancer was 22.09% (95% CI: - 13.75-57.94, I = 95.5%).

CONCLUSION

There is a significant global burden of UTIs (34.39%) in oncologic patients. This requires regular screening of UTIs in oncologic patients to minimize further complications, better monitoring, and early treatment.