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. 2022 Mar 1;11(5):1359.
doi: 10.3390/jcm11051359.

Adverse Clinical Outcomes among Inflammatory Bowel Disease Patients Treated for Urinary Tract Infection

Offir Ukashi  1   2   3 , Yiftach Barash  3   4   5 , Eyal Klang  3   4   5 , Tal Zilberman  3   6 , Bella Ungar  1   3 , Uri Kopylov  1   3 , Shomron Ben-Horin  1   3 , Ido Veisman  1   3
Affiliations

Adverse Clinical Outcomes among Inflammatory Bowel Disease Patients Treated for Urinary Tract Infection

Offir Ukashi et al. J Clin Med. .

Abstract

Background: Urinary tract infection (UTI) is the most common urologic complication among patients with inflammatory bowel disease (IBD). However, data regarding UTI outcomes in this population are scarce. We aimed to evaluate adverse outcomes of UTI among patients with IBD. Methods: This was a retrospective cohort study of consecutive adult patients who visited the emergency room (ER) at Sheba Medical Center due to a UTI between 2012 and 2018. Data included demographic and clinical variables. UTI cases were extracted using ICD-10 coding. Results: Of 21,808 (ER) visits with a UTI, 122 were IBD patients (Crohn’s disease—52, ulcerative colitis—70). Contrary to non-IBD subjects, patients with IBD had higher rates of hospitalization, acute kidney injury (AKI) and 30 day-recurrent hospitalization (59.3% vs. 68.9%, p = 0.032; 4.6% vs. 13.9%, p < 0.001; 7.3% vs. 15.6%, p = 0.001, respectively). Among patients with IBD, advanced age (p = 0.005) and recent hospitalization (p = 0.037) were associated with increased risk for hospitalization, while hydronephrosis (p = 0.005), recent hospitalization (p = 0.011) and AKI (p = 0.017) were associated with increased 30-day recurrent hospitalization. Neither immunosuppressants nor biologics were associated with UTI outcomes among patients with IBD. Conclusions: Patients with IBD treated for a UTI had higher rates of hospitalization, AKI and 30-day recurrent hospitalization than non-IBD patients. No association was observed between immunosuppressants or biologics and UTI outcomes.

Keywords: 30-day-recurrent hospitalization; Crohn’s disease; acute kidney injury; inflammatory bowel disease; ulcerative colitis; urinary tract infection.

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Conflict of interest statement

U.K.: speaker and advisory fees—Abbvie, Jannsen Takeda Medtronic; research support—Jannsen Takeda Medtronic. S.B.H.: consulting and advisory board fees and/or research support—Abbvie, MSD, Janssen, Takeda and CellTrion. B.U.: consultation fees—Takeda, Neopharm, Janssen and Abbvie. I.V.: consultation fees—Galmed. The remaining authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart. Abbreviations: ER, emergency room; UTI, urinary tract infection; IBD, inflammatory bowel disease; CD, Crohn’s disease; UC, ulcerative colitis.
Figure 2
Figure 2
Frequency distribution of uropathogens grown in urine cultures among inflammatory bowel disease patients treated for UTIs. Abbreviations: ESBL, extended-spectrum beta-lactamase; UTI, urinary tract infection; CONS, coagulase-negative staphylococci. * Streptococcal species; other than enterococci.
See this image and copyright information in PMC

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