Risk Factors for Urinary Tract Infections in Postmenopausal Women

Hu, Kent K.; Boyko, Edward J.; Scholes, Delia; Normand, Esther H.; Chen, Chi Ling; Grafton, Jane; Fihn, Stephan D.

doi:10.1001/archinte.164.9.989

Cited by 139 publications

(86 citation statements)

References 18 publications

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“…Urinary incontinence has been described as a risk factor [3,15]. In contrast to some earlier studies, we did not find insulin therapy to be a predictor for UTIs [15,16].…”

Section: Discussioncontrasting

confidence: 99%

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A clinical prediction rule for urinary tract infections in patients with type 2 diabetes mellitus in primary care

et al. 2008

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SUMMARYWe aimed to develop a prediction rule for urinary tract infections (UTIs) in patients with type 2 diabetes mellitus (DM2). A 12-month prospective cohort study was conducted in patients with DM2 aged o45 years to predict the occurrence of recurrent UTIs in women and lower UTIs in men. Predictors for recurrent UTI in women (n=81, 2%) and lower UTIs in men (n=93, 3%) were age, number of general practitioner (GP) visits, urinary incontinence, cerebrovascular disease or dementia. In women, renal disease was an additional predictor. The optimum corrected area under the receiver-operating curve (AUC) was 0 . 79 (95 % CI 0 . 74-0 . 83) for women and 0 . 75 (95 % CI 0 . 70-0 . 80) for men. Using a cut-off score of 4, women with a lower risk assignment had a probability of 0 . 3 % for the outcome. For a cut-off score of 6, women with a higher risk assignment had a probability of 5 . 8 %. For men these figures were 0 . 8 and 7 . 1 for a cut-off score of 2 and 4, respectively. Simple variables can be used for the risk stratification of patients.

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“…Urinary incontinence has been described as a risk factor [3,15]. In contrast to some earlier studies, we did not find insulin therapy to be a predictor for UTIs [15,16].…”

Section: Discussioncontrasting

confidence: 99%

“…Studies show that 20-30% of women will have recurrent episodes during their lifetime [1]. Patients with diabetes mellitus (DM) have an increased risk of UTIs [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

A clinical prediction rule for urinary tract infections in patients with type 2 diabetes mellitus in primary care

et al. 2008

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“…In addition, in contrast to most earlier studies in which the recurrence rate of UTIs were described (2,6,7), we also compared the different treatment strategies between women with and without diabetes and analyzed pre-and postmenopausal women separately. The risk factors for UTIs are partly different in pre-and postmenopausal women (13,14), and therefore they should not be regarded as identical entities. Furthermore, it is only possible to interpret the recurrence rates when the initial treatment strategies of the two groups are known.…”

Section: Secondary Analysesmentioning

confidence: 99%

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

Schneeberger

Stolk

DeVries³

et al. 2008

Diabetes Care

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OBJECTIVE -Women with diabetes have a high incidence and complication rate of urinary tract infections (UTIs). Our aims were to compare current treatment strategies with respect to recurrence rates in women with diabetes with those without diabetes.RESEARCH DESIGN AND METHODS -We used a Dutch registration database containing pharmacy dispensing data. A total of 10,366 women with diabetes (17.5% premenopausal) (aged Յ55 years) and 200,258 women without diabetes (68% premenopausal) who received a first course of trimethoprim, nitrofurantoin, fosfomycin, or norfloxacin between January 1999 and January 2006 were included. We compared short (Յ5 days) with long (Ͼ5 days) prescriptions and norfloxacin with trimethoprim, nitrofurantoin, and fosfomycin. A recurrence was defined as a second prescription for one of the above-mentioned agents or a first with amoxicillin (clavulanic acid), fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after inclusion.RESULTS -Premenopausal women with diabetes more often received a long (26.5 vs. 19.2%; P Ͻ 0.001) treatment with norfloxacin (10.7 vs. 6.2%; P Ͻ 0.001) but still had a higher recurrence rate (16.1 vs. 12.2%; P ϭ 0.003) compared with those without diabetes. Similarly, postmenopausal women with diabetes more often received a longer (32.8 vs. 28.8%; P Ͻ 0.001) treatment with norfloxacin (15.2 vs. 12.7%; P Ͻ 0.001) but had a higher recurrence rate (19.1 vs. 16.4%; P Ͻ 0.001) compared with those without diabetes.CONCLUSIONS -Despite the fact that patients with diabetes more often received longer and more potent initial treatment than patients without diabetes, pre-and postmenopausal women with diabetes more often had recurrences of their UTIs.

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“…A history of UTI, any and recent, has been a consistently reported risk factor for subsequent cystitis in both young adult and postmenopausal women (9,11,17,(20)(21)(22)(23). A previous UTI may predispose to subsequent UTI through behavioral, microbiological, or genetic factors.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Acute Pyelonephritis in Healthy Women

2005

Obstetrics & Gynecology

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Risk Factors for Urinary Tract Infections in Postmenopausal Women

Cited by 139 publications

References 18 publications

A clinical prediction rule for urinary tract infections in patients with type 2 diabetes mellitus in primary care

A clinical prediction rule for urinary tract infections in patients with type 2 diabetes mellitus in primary care

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

Risk Factors Associated With Acute Pyelonephritis in Healthy Women

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