Urinary tract infections (UTIs) are common among college-aged women and often recur. Some antibiotics recommended to treat UTIs trigger dysbiosis of intestinal and vaginal microbiomes – where uropathogens originate, though few studies have investigated associations between these therapies with recurrent infections. We retrospectively analysed the electronic medical records of 6651 college-aged women diagnosed with a UTI at a US university student health centre between 2006 and 2014. Women were followed for 6 months for incidence of a recurrent infection. In a secondary analysis, associations in women whose experienced UTI recurrence within 2 weeks were also considered for potential infection relapse. Logistic regression was used to assess associations between infection recurrence or relapse and antibiotics prescribed, in addition to baseline patient characteristics including age, race/ethnicity, region of origin, year of encounter, presence of symptomology, pyelonephritis, vaginal coinfection and birth control consultation. There were 1051 instances of infection recurrence among the 6620 patients, indicating a prevalence of 16%. In the analysis of patient characteristics, Asian women were statistically more likely to experience infection recurrence whereas African American were less likely. No significant associations were identified between the antibiotic administered at the initial infection and the risk of infection recurrence after multivariable adjustment. Treatment with trimethoprim-sulphamethoxazole and being born outside of the USA were significantly associated with increased odds of infection relapse in the multivariate analysis. The results of the analyses suggest that treatment with trimethoprim-sulphamethoxazole may lead to an increased risk of UTI relapse, warranting further study.

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Background Measures to protect against the spread of COVID-19 include guidance on personal and environmental hygiene. Some guidelines related to COVID-19 directly align with or have similarity to evidence-based food safety practices (FSP) taught in nutrition education classes, including handwashing and washing produce before eating. Objective To understand the impacts of the COVID-19 pandemic on youth handwashing and washing produce before eating behaviors. Study Design, Setting, Participants Data were collected from youth (N = 1,098) in grades 3-5 who participated in SNAP-Education (SNAP-Ed) and the Expanded Food and Nutrition Education Program (EFNEP) in Florida. Utilizing common self-report survey measures, baseline measures from 3 years prior to the pandemic and 3 months during the pandemic were compared for handwashing before eating and washing produce before eating. Due to incomplete data collection during the first 8 months of the pandemic, only behaviors from October 20-January 31 intervals (October 2018- January 2021) were compared to control for seasonal differences. Measurable Outcomes/Analysis Behavioral measures are based on a frequency scale from 1 to 4 (4 being the most frequent). An independent samples t test was used to compare baseline FSP scores from intervals before and during the pandemic. Results No significant difference was found in the frequency of handwashing before and during COVID-19 (3.16 vs 3.18, respectively; P = 0.76). A significant increase was found in the frequency of washing produce before eating before and during COVID-19 (3.14 vs 3.31, respectively; P = 0.008). Conclusion This study did not find any significant changes in handwashing frequency during COVID-19, however, a significant increase in washing produce prior to eating was found. Handwashing prior to eating is a current CDC guideline for COVID-19 mitigation while washing produce prior to eating is not (CDC 2021). Changes in lifestyle and/or eating arrangements during the pandemic might explain these findings. Funding Supplemental Nutrition Assistance Program - Education.

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