Sporadic compared to recurrent urinary tract infections: Considerations for urogynecologic patients

Aims To describe the uropathogens and antimicrobial resistance patterns in women with singular, sporadic urinary tract infection (UTI) vs those with recurrent UTI (rUTI) in a urogynecologic population. Methods This was a cross-sectional analysis of women treated for a UTI by a urogynecologic provider in a 1-year timeframe. Subjects were divided into two groups: (a) sporadic UTI-no history of rUTI and a single infection in the study timeframe and (b) rUTI-history of rUTI and >= 2 UTIs in the study timeframe. Our primary outcome was the difference in uropathogens between groups. Secondary aims were to investigate host characteristics associated with recurrentEscherichia coliinfections and resistant uropathogens in the rUTI cohort. Results We had 265 women with 163 (61.5%) in the sporadic UTI group and 102 (38.5%) in the rUTI group. The most common uropathogens wereE. coli(57.3%) andKlebsiella(11.7%). In the rUTI group, only 27 of 102 (26.5%) had allE. coliinfections. There were differences between groups regarding age (P = .03) and proportion of neurogenic bladder (P = .01), intermittent self-catheterization (P < .01), antibiotic suppression (P < .01), and vaginal estrogen therapy (P < .01). In the rUTI cohort, there were no risk factors that were significantly associated with recurrentE.coliUTIs and vaginal estrogen therapy was associated with a higher odds of sensitive uropathogens (adjusted odds ratio, 3.12; confidence interval, 1.28-7.56). Conclusions In those with rUTI, it was uncommon to have recurringE. coliUTIs and consistently sensitive uropathogens. Pretreatment urine cultures are important to verify causative uropathogens in this population.