Hooton T M, Scholes D, Hughes J P, Winter C, Roberts P L, Stapleton A E, Stergachis A, Stamm W E
Department of Medicine, University of Washington School of Medicine, Seattle, 98122, USA.
N Engl J Med. 1996 Aug 15;335(7):468-74. doi: 10.1056/NEJM199608153350703.
Although acute urinary tract infections are common in young women, the associated risk factors have not been defined prospectively.
We recruited sexually active young women who were starting a new method of contraception at a university health center or a health maintenance organization (HMO) and monitored them for six months for symptomatic urinary tract infections. Daily diaries and serial interviews were used to collect data on potential risk factors.
Among 796 women, the incidence of urinary tract infections per person-year was 0.7 in the university cohort (mean age, 23 years; n = 348) and 0.5 in the HMO cohort (mean age, 29; n = 448). In both cohorts, there were strong dose-response relations between the risk of infection and both recent use of a diaphragm with spermicide (respective relative risks for one, three, and five days of use in the past week, 1.42, 2.83, and 5.68 in the university cohort, P<0.001; and 1.29, 2.14, and 3.54 in the HMO cohort, P=0.04) and recent sexual intercourse (respective relative risks for one, three, and five days with intercourse in the past week, 1.37, 2.56, and 4.81 in the university cohort, P<0.001; and 1.24, 1.91, and 2.96 in the HMO cohort, P=0.002). The risk of acute infection was also associated with a history of recurrent infection (relative risk, 5.58 in the university group and 2.10 in the HMO group) but not with cervical-cap use, ABO-blood-group nonsecretor phenotype, or delayed postcoital voiding.
Among sexually active young women the incidence of symptomatic urinary tract infection is high, and the risk is strongly and independently associated with recent sexual intercourse, recent use of a diaphragm with spermicide, and a history of recurrent urinary tract infections.
尽管急性尿路感染在年轻女性中很常见，但相关危险因素尚未经过前瞻性定义。
我们招募了在大学健康中心或健康维护组织（HMO）开始采用新避孕方法的性活跃年轻女性，并对她们进行为期六个月的有症状尿路感染监测。通过每日日记和系列访谈收集潜在危险因素的数据。
在796名女性中，大学队列（平均年龄23岁；n = 348）每人年尿路感染发生率为0.7，HMO队列（平均年龄29岁；n = 448）为0.5。在两个队列中，感染风险与近期使用含杀精剂的隔膜（大学队列中过去一周使用一天、三天和五天的相对风险分别为1.42、2.83和5.68，P<0.001；HMO队列中分别为1.29、2.14和3.54，P = 0.04）以及近期性交（大学队列中过去一周性交一天、三天和五天的相对风险分别为1.37、2.56和4.81，P<0.001；HMO队列中分别为1.24、1.91和2.96，P = 0.002）之间均存在强剂量反应关系。急性感染风险还与复发性感染史相关（大学组相对风险为5.58，HMO组为2.10），但与使用宫颈帽、ABO血型非分泌型表型或性交后延迟排尿无关。
在性活跃的年轻女性中，有症状尿路感染的发生率很高，且风险与近期性交、近期使用含杀精剂的隔膜以及复发性尿路感染史密切且独立相关。
