Seasonality of urinary tract infections in the United Kingdom in different age groups: longitudinal analysis of The Health Improvement Network (THIN)

Abstract

Evidence regarding the seasonality of urinary tract infection (UTI) consultations in primary care is conflicting and methodologically poor. To our knowledge, this is the first study to determine whether this seasonality exists in the UK, identify the peak months and describe seasonality by age. The monthly number of UTI consultations (N = 992 803) and nitrofurantoin and trimethoprim prescriptions (N = 1 719 416) during 2008-2015 was extracted from The Health Improvement Network (THIN), a large nationally representative UK dataset of electronic patient records. Negative binomial regression models were fitted to these data to investigate seasonal fluctuations by age group (14-17, 18-24, 25-45, 46-69, 70-84, 85+) and by sex, accounting for a change in the rate of UTI over the study period. A September to November peak in UTI consultation incidence was observed for ages 14-69. This seasonality progressively faded in older age groups and no seasonality was found in individuals aged 85+, in whom UTIs were most common. UTIs were rare in males but followed a similar seasonal pattern than in females. We show strong evidence of an autumnal seasonality for UTIs in individuals under 70 years of age and a lack of seasonality in the very old. These findings should provide helpful information when interpreting surveillance reports and the results of interventions against UTI.

Antibiotic prescribing for lower UTI in elderly patients in primary care and risk of bloodstream infection: A cohort study using electronic health records in England

“…Urinary tract infections (UTIs) are common in older adults in both primary and secondary care [1], with Escherichia coli as the causative pathogen in 70%-95% of cases [2]. The clinical spectrum of UTI ranges from mild urinary symptoms to urosepsis, but the rate of E. coli bloodstream infection is highest in the oldest age groups (758.5/100,000 in �85 years versus 53.4/ 100,000 in 45-64-year-olds) [3].…”

“…Urinary tract infections (UTIs) are common in older adults in both primary and secondary care [ 1 ], with Escherichia coli as the causative pathogen in 70%–95% of cases [ 2 ]. The clinical spectrum of UTI ranges from mild urinary symptoms to urosepsis, but the rate of E .…”

Summer, sun and sepsis—The influence of outside temperature on nosocomial bloodstream infections: A cohort study and review of the literature

“…Recent studies revealed strong evidence that urinary tract infections peak in autumn [3]. Likewise, the risk of surgical site infections is also highly seasonal and is associated with warmer weather [4] [5].…”

Microbiota and infection prevention: making space for probiotics in healthcare

“…© 2018 MA Healthcare Ltd I nfections cause a major burden to both patients and the healthcare system. The beginning of the cold months usually entails a shift in the prevalence of many infections, starting with autumnal seasonality for urinary tract infections in individuals under 70 years of age and followed by rises in cases of acute gastroenteritis (AGE)historically known as 'winter vomiting disease'and respiratory tract infections, increasing risks of antibiotic-associated diarrhoea (AAD) and Clostridium difficile infections (CDI) and a reduction of surgical infections (SI) of commonly performed procedures (Gilca et al, 2012;Durkin et al, 2015;Torner et al, 2016;Rosello et al, 2018). This shift in infection patterns in the autumn and winter warrants the regular review of standard practice and examination of new evidence, in order to optimise patient outcomes.…”