Development and validation of a nomogram predicting recurrence risk in women with symptomatic urinary tract infection

Cai, Tommaso; Mazzoli, Sandra; Migno, Serena; Malossini, G.; Lanzafame, Paolo; Mereu, Liliana; Tateo, Saverio; Wagenlehner, Florian M. E.; Pickard, Robert; Bartoletti, Riccardo

doi:10.1111/iju.12453

Cited by 31 publications

(43 citation statements)

References 26 publications

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“…Many researchers, however, have developed different patient-reported diagnostic tools, scoring systems, and algorithms for accurate diagnosis of AC and nomograms, to predict the risk of recurrence based on history and symptoms, after the initial episode of AC [13,33,[44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

et al. 2018

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Background and Objectives: Acute uncomplicated cystitis (AC) is common among women. Acute onset of specific typical symptoms may serve as reliable criteria for developing a cost-effective strategy to make an accurate diagnosis of AC. We aimed to evaluate the diagnostic values of most common symptoms and signs of AC depending on their presence and severity. Methods: The current trial was designed as a case-control study. Data derived from the Acute Cystitis Symptom Score (ACSS) database were analyzed. Diagnostic values of the symptoms and their severity were assessed via the calculations of the sensitivity and specificity, odds ratio, positive and negative likelihood ratios. The strength of associations was estimated by the coefficient of correlation (Pearson’s R). Results: Data from 819 female subjects (423 Patients, 396 controls) with the mean age of 37.1 ± 15.3 were analyzed. Highest diagnostic values for AC in this study belonged to dysuria, urgency, and frequency. Interestingly, complaints of vaginal discharge was not found to decrease the odds for having AC in the study population. Conclusions: The severity of the symptom is even more essential than just its presence for an accurate diagnosis. The ACSS is an accurate tool and may be recommended for clinical practice and studies for diagnosis of AC in women. Further studies and unification of terms are need.

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Section: Discussionmentioning

confidence: 99%

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

et al. 2018

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“…Cai et al also found that the most important factors affecting the risk of new recurrences were: bowel function, presence of Gram negative strains, asymptomatic bacteriuria treatment and having had 3 or more than 3 UTI episodes (40). The importance of bowel function for development of UTI is well known and is related to the fecal-perineal-urethral contamination by enteric bacteria (40). The risk is of UTI is increased by constipation as demonstrated by LoeningBaucke et al (41).…”

Section: Assessment Of Patients' Behaviour and Bacterial Related Riskmentioning

confidence: 99%

“…Recently, Cai et al developed and validated a nomogram that accurately predicts the recurrence risk of urinary tract infection at 12 months, and which can assist in identifying women at high risk of symptomatic recurrence that can be suitable candidates for a prophylactic strategy (40). In this model they found the following independent predictors of UTI recurrence: number of sexual partners, bowel function, type of pathogens isolated (Gram-positive/negative), hormonal status, number of UTI recurrences and previous treatment of asymptomatic bacteriuria (40). In this model they excluded use of food supplements because of the high variability of products used.…”

Section: Assessment Of Patients' Behaviour and Bacterial Related Riskmentioning

confidence: 99%

“…In this model they excluded use of food supplements because of the high variability of products used. Cai et al also found that the most important factors affecting the risk of new recurrences were: bowel function, presence of Gram negative strains, asymptomatic bacteriuria treatment and having had 3 or more than 3 UTI episodes (40). The importance of bowel function for development of UTI is well known and is related to the fecal-perineal-urethral contamination by enteric bacteria (40).…”

Section: Assessment Of Patients' Behaviour and Bacterial Related Riskmentioning

confidence: 99%

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The role of nutraceuticals and phytotherapy in the management of urinary tract infections: What we need to know?

Cai

Tamanini

Kulchavenya

et al. 2017

Arch Ital Urol Androl

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Urinary Tract Infections (UTIs) are amongst the most common infectious diseases and carry a significant impact on patient quality of life and health care costs. Despite that, there is no well-established recommendation for a "standard" prophylactic antibiotic management to prevent UTI recurrences. The majority of patients undergoes long-term antibiotic treatment that severely impairs the normal microbiota and increases the risk of development of multidrugresistant microorganisms. In this scenario, the use of phytotherapy to both alleviate symptoms related to UTI and decrease the rate of symptomatic recurrences is an attractive alternative. Several recently published papers report conflicting findings and cannot give confident recommendations for the everyday clinical practice. A new approach to the management of patients with recurrent UTI might be to use nutraceuticals or phytotherapy after an accurate assessment of the patient`s risk factors. No single compound or mixture has been identified so far as the best preventive approach in patients with recurrent UTI. We reviewed our non-antibiotic approach to the management of recurrent UTI patients in order to clarify the evidence-base for the commonly used substances, understand their pharmacokinetics and pharmacodynamics in order to tailor the best way to improve patient's quality of life and reduce the rate of antibiotic resistance. Lack of a gold-standard recommendation and the risk of increasing antibiotic resistance is the reason why we need alternatives to antibiotics in the management of urinary tract infections (UTIs). A tailored approach according to bacterial characteristics and the patient risk factors profile is a promising option.KEY WORDS: Nutraceuticals; Phytotherapy; Urinary tract infections.Submitted 13 January 2017; Accepted 28 January 2017 SummaryNo conflict of interest declared.

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“…First of all, I sincerely welcome this novel nomogram, lower urinary tract infection recurrence risk (LUTIRE), which predicts the risk of recurrence of symptomatic urinary tract infection (UTI) in women . The authors made a comprehensive list of candidate predictors and analyzed them statistically.…”

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confidence: 99%

Editorial Comment from Dr Takahashi to Development and validation of a nomogram predicting recurrence risk in women with symptomatic urinary tract infection

Takahashi

2014

Int J of Urology

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Development and validation of a nomogram predicting recurrence risk in women with symptomatic urinary tract infection

Abstract: Conclusions:The present nomogram accurately predicts the recurrence risk of urinary tract infection at 12 months, and can assist in identifying women at high risk of symptomatic recurrence that can be suitable candidates for a prophylactic strategy.

Cited by 31 publications

References 26 publications

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

The role of nutraceuticals and phytotherapy in the management of urinary tract infections: What we need to know?

Editorial Comment from Dr Takahashi to Development and validation of a nomogram predicting recurrence risk in women with symptomatic urinary tract infection

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