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. 2022 May;33(5):1311-1317.
doi: 10.1007/s00192-022-05132-6. Epub 2022 Mar 30.

Incidence of urosepsis or pyelonephritis after uncomplicated urinary tract infection in older women

Megan S Bradley  1   2 , Cassie Ford  3 , Michael Stagner  3 , Victoria Handa  4 , Jerry Lowder  5
Affiliations

Incidence of urosepsis or pyelonephritis after uncomplicated urinary tract infection in older women

Megan S Bradley et al. Int Urogynecol J. 2022 May.

Abstract

Introduction and hypothesis: Our primary aim was to describe the incidence of the diagnosis of urosepsis or pyelonephritis during the 60 days following initial evaluation of an uncomplicated urinary tract infection (UTI) among female Medicare beneficiaries ≥ 65 years of age.

Study design: This was a retrospective cohort study of women ≥ 65 years of age undergoing evaluation for an incident, uncomplicated urinary tract infection (UTI) between the years 2011-2018 included in the Medicare 5% Limited Data Set (LDS). We grouped women into age categories of 65-74 years, 75-84 years, or > 84 years old. We excluded women with possible complicated UTI, those hospitalized within 60 days prior to index UTI evaluation, and those residing in a nursing home and place of service consistent with an inpatient setting/facility. The association between age and risk of each outcome was estimated with Cox proportional hazards models, controlling for relevant comorbidities.

Results: Between 2011-2018, 169,958 women met our inclusion/exclusion criteria and were evaluated for uncomplicated UTI. In total, 2935 (1.7%) had a subsequent diagnosis of either urosepsis (n = 2848, 1.6%) or pyelonephritis (n = 145, 0.08%). In adjusted analysis, the hazard of urosepsis was significantly higher for women > 84 years (aHR 1.49, 95% CI 1.38, 1.65; p < 0.01) and those aged 75-84 (aHR 1.24, 95% CI 1.13, 1.37; p < 0.01) compared to those aged 65-74 years. In contrast, age group was not significantly associated with the hazard for pyelonephritis.

Conclusions: Urosepsis and pyelonephritis are very uncommon after evaluation of incident uncomplicated UTI in female medical beneficiaries ≥ 65 years of age.

Keywords: Pyelonephritis; Urinary tract infection; Urosepsis.

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Conflict of interest statement

Declarations

Conflicts of interest None.

Figures

Fig. 1
Fig. 1
Consort diagram
Fig. 2
Fig. 2
Incidence of urosepsis diagnosis in the 60 days following evaluation for uncomplicated urinary tract infection among age groups
Fig. 3
Fig. 3
Incidence of pyelonephritis diagnosis in the 60 days following evaluation for uncomplicated urinary tract infection among age groups
See this image and copyright information in PMC

Comment in

  • Geriatrics.
    Griebling TL. Griebling TL. J Urol. 2023 Feb;209(2):425-427. doi: 10.1097/JU.0000000000003075. Epub 2022 Nov 18. J Urol. 2023. PMID: 36398532 No abstract available.

References

    1. Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. Med Clin North Am. 2011;95:27–41. 10.1016/j.mcna.2010.08.023. - DOI - PubMed
    1. Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010;7:653–60. 10.1038/nrurol.2010.190. - DOI - PubMed
    1. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002;113(Suppl):5s–13s. - PubMed
    1. Foxman B. Urinary tract infection syndromes. Occurrence, recurrence, bacteriology, risk factors, and disease burden. Infectious Disease Clin North Am. 2014;28(1):1–13. 10.1016/j.idc.2013.09.003. - DOI - PubMed
    1. Knottnerus BJ, Geerlings SE, van Charante EPM, ter Riet G. Women with symptoms of uncomplicated urinary tract infection are often willing to delay antibiotic treatment: A prospective cohort study. BMC Family Pract. 2013;14:71. 10.1186/1471-2296-14-71. - DOI - PMC - PubMed

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