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Review
. 2019 May 2:11:1756287218814382.
doi: 10.1177/1756287218814382. eCollection 2019 Jan-Dec.

Risk factors and predisposing conditions for urinary tract infection

Oscar Storme  1 , José Tirán Saucedo  2 , Arturo Garcia-Mora  3 , Manuel Dehesa-Dávila  4 , Kurt G Naber  5
Affiliations
Review

Risk factors and predisposing conditions for urinary tract infection

Oscar Storme et al. Ther Adv Urol. .

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.

Keywords: asymptomatic bacteriuria; catheterization; genital prolapse; incontinence; neurogenic bladder dysfunction; pregnancy; risk factors; urinary tract infections.

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Conflict of interest statement

Conflict of interest statement: Dr García Mora is a speaker for Allergan, Lilly Icos, Novartis, Ferring, Aspen, Vifor Pharma Group and Asofarma and a proctor for Medtronic and Boston Scientific. Dr Naber has acted as an investigator, consultant or speaker for Basilea, Bionorica, Daiichi Sankyo, Enteris Biopharma, Helperby Therapeutics, Hermes, Leo Pharma, MerLion, Vifor Pharma Group, Paratek, Pierre Fabre, Roche, Rosen Pharma, and Zambon. Dr Tirán has acted as a speaker, consultant or researcher for Janssen Cilag, MSD, Boehringer Ingeheim, Pfizer, GSK, Cubist Pharmaceuticals, Vifor Pharma Group, BMS, and Grunenthal. Dr Storme has acted as a speaker for Vifor Pharma Group. Dr Dehesa-Dávila is consultant or speaker for Grunenthal, Pfizer, Vifor Pharma Group and Boehringer Ingelheim.

Figures

Figure 1.
Figure 1.
Nomogram for the prediction of 12-month UTI recurrence risk. UTI, urinary tract infection.
See this image and copyright information in PMC

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