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Risk factors and predisposing conditions for urinary tract infection.

Abstract

Understanding individual and population-specific risk factors associated with recurrent urinary tract infections (UTIs) can help physicians tailor prophylactic strategies. Frequent intercourse, vulvovaginal atrophy, change of the local bacterial flora, history of UTIs during premenopause or in childhood, family history, and a nonsecretor blood type are substantiated risk factors for recurrent uncomplicated UTIs. This is a narrative review based on relevant literature according to the experience and expertise of the authors. Asymptomatic bacteriuria is generally benign; however, during pregnancy it is more common and is associated with an increased likelihood of symptomatic infection, which may harm the mother or fetus. Screening of pregnant women and appropriate treatment with antimicrobials must be balanced with the potential for adverse treatment-related outcomes; appropriate prophylaxis should be considered where possible. High-quality data are currently lacking on risks related to asymptomatic bacteriuria in pregnancy and further data in this hard-to-study population should be a primary concern for researchers. Incomplete voiding represents the primary risk factor for UTIs associated with conditions such as urinary incontinence and prolapse. Correcting the presence of residual urine remains the most effective prophylaxis in these populations. Bladder function alters throughout life; however, changes in function may be particularly profound in clinical populations at high risk of UTIs. Patients with neurogenic bladder will also likely have other evolving medical issues which increase the risk of UTIs, such as repeated catheterization and increasing residual urine volume. More aggressive antimicrobial prophylactic strategies may be appropriate in these patients. Again, the paucity of data on prophylaxis in these high-risk patients requires the attention of the research community.

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  • Authors+Show Affiliations

    ,

    Padre Hurtado Hospital, Universidad del Desarrollo, Calle Esperanza 2150, Paradero 28, Santa Rosa, San Ramón, Chile.

    ,

    Instituto Mexicano de Infectología, Ginecología y Obstetrica, Universidad de Monterrey, Monterrey, Mexico.

    ,

    Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

    ,

    Hospital Español, Mexico City, Mexico.

    Technical University of Munich, Munich, Germany.

    Source

    Therapeutic advances in urology 11: pg 1756287218814382

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    31105772

    Citation

    Storme, Oscar, et al. "Risk Factors and Predisposing Conditions for Urinary Tract Infection." Therapeutic Advances in Urology, vol. 11, 2019, p. 1756287218814382.
    Storme O, Tirán Saucedo J, Garcia-Mora A, et al. Risk factors and predisposing conditions for urinary tract infection. Ther Adv Urol. 2019;11:1756287218814382.
    Storme, O., Tirán Saucedo, J., Garcia-Mora, A., Dehesa-Dávila, M., & Naber, K. G. (2019). Risk factors and predisposing conditions for urinary tract infection. Therapeutic Advances in Urology, 11, p. 1756287218814382. doi:10.1177/1756287218814382.
    Storme O, et al. Risk Factors and Predisposing Conditions for Urinary Tract Infection. Ther Adv Urol. 2019;11:1756287218814382. PubMed PMID: 31105772.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk factors and predisposing conditions for urinary tract infection. AU - Storme,Oscar, AU - Tirán Saucedo,José, AU - Garcia-Mora,Arturo, AU - Dehesa-Dávila,Manuel, AU - Naber,Kurt G, Y1 - 2019/05/02/ PY - 2018/10/09/received PY - 2018/10/27/accepted PY - 2019/5/21/entrez PY - 2019/5/21/pubmed PY - 2019/5/21/medline KW - asymptomatic bacteriuria KW - catheterization KW - genital prolapse KW - incontinence KW - neurogenic bladder dysfunction KW - pregnancy KW - risk factors KW - urinary tract infections SP - 1756287218814382 EP - 1756287218814382 JF - Therapeutic advances in urology JO - Ther Adv Urol VL - 11 N2 - Understanding individual and population-specific risk factors associated with recurrent urinary tract infections (UTIs) can help physicians tailor prophylactic strategies. Frequent intercourse, vulvovaginal atrophy, change of the local bacterial flora, history of UTIs during premenopause or in childhood, family history, and a nonsecretor blood type are substantiated risk factors for recurrent uncomplicated UTIs. This is a narrative review based on relevant literature according to the experience and expertise of the authors. Asymptomatic bacteriuria is generally benign; however, during pregnancy it is more common and is associated with an increased likelihood of symptomatic infection, which may harm the mother or fetus. Screening of pregnant women and appropriate treatment with antimicrobials must be balanced with the potential for adverse treatment-related outcomes; appropriate prophylaxis should be considered where possible. High-quality data are currently lacking on risks related to asymptomatic bacteriuria in pregnancy and further data in this hard-to-study population should be a primary concern for researchers. Incomplete voiding represents the primary risk factor for UTIs associated with conditions such as urinary incontinence and prolapse. Correcting the presence of residual urine remains the most effective prophylaxis in these populations. Bladder function alters throughout life; however, changes in function may be particularly profound in clinical populations at high risk of UTIs. Patients with neurogenic bladder will also likely have other evolving medical issues which increase the risk of UTIs, such as repeated catheterization and increasing residual urine volume. More aggressive antimicrobial prophylactic strategies may be appropriate in these patients. Again, the paucity of data on prophylaxis in these high-risk patients requires the attention of the research community. SN - 1756-2872 UR - https://www.unboundmedicine.com/medline/citation/31105772/Risk_factors_and_predisposing_conditions_for_urinary_tract_infection L2 - http://journals.sagepub.com/doi/full/10.1177/1756287218814382?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -