Factors Associated With a Positive Urine Culture in Women Seeking Urogynecologic Care for Urinary Tract Infection Symptoms

Abstract

Importance: Urinary tract infections (UTIs) are one of the most common bacterial infections and more frequently affect women than men.

Objectives: Our objective was to determine clinical characteristics associated with a positive urine culture in women seeking treatment for symptoms of UTI.

Study design: In this prospective cohort study, women seeking treatment for UTI symptoms were administered the Urinary Tract Infection Symptom Assessment questionnaire at baseline and at the time of culture results. Participants were grouped by history of recurrent UTI (rUTI) based on chart review. Our primary outcome was the proportion of "positive" urine cultures (≥10 3 colony-forming units) compared between rUTI groups. Characteristics were compared and the relative odds of a positive culture were calculated with a logistic regression model.

Results: Analyses included 152 women, 79 (52%) with rUTI and 73 (48%) with no history of rUTI. Overall, 90 (59.2%) had a positive culture. Participants with a positive culture were more likely to report history of rUTI ( P = 0.01). There was a 2.45-fold increased adjusted odds of a positive culture in those with a history of rUTI (adjusted odds ratio [aOR], 2.45; 95% confidence interval [CI], 1.34-5.03; P = 0.01) when controlling for confounding variables, including scores on the Urinary Tract Infection Symptom Assessment for frequency (aOR, 0.59; 95% CI, 0.40-0.91), dysuria (aOR, 1.53; 95% CI, 1.10-2.12), and age (aOR, 1.02; 95% CI, 1.01-1.05).

Conclusions: In a cohort of women seeking care for UTI symptoms, older women, those with a history of rUTI and those presenting with dysuria are more likely to have a positive urine culture compared with those with urinary frequency.