Mp26-06 Recurrent Urinary Tract Infections Due to Bacterial Persistence or Reinfection in Women: Does This Factor Impact Upper Tract Imaging Findings?
Year: 2016
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND OBJECTIVES:To compare the rate of upper tract imaging abnormalities between recurrent UTI (RUTI) due to bacterial persistence or reinfection.METHODS: Following IRB approval, a prospectively maintained database of women with documented RUTIs (¼ 3 UTI/year) and extensive trigonitis was reviewed for demographic data (race, gravidity, parity, diabetes, immunosuppression, sexual activity), urine culture findings, and radiology-interpreted upper tract imaging study (renal ultrasound (US), CT scan, IVP) findings.Patients with irretrievable images, absent or incomplete urine culture results for review, no imaging study performed, an obvious source for RUTI (intermittent catheterization, indwelling catheter, > stage 2 anterior prolapse, neurogenic bladder), or history of pyelonephritis were excluded.1 RESULTS: From 2006 to 2014, 116 of 289 women with RUTIs met inclusion criteria.Mean age was 65.0Æ14.4with 95% being Caucasian and 81% post-menopausal.Nearly one-third were sexually active and none has prolapse >stage 2. Forty-one percent (48/116) had persistent and 59% (68/116) had reinfection RUTI.Imaging studies included US alone (52), CT alone (26), US and CT (31), and IVP with US/CT (7).Of total imaging findings (N¼58 in 55 women), 57/58 (98%) were noncontributory.All imaging findings were organized according to the urine culture findings (bacterial persistence or reinfection RUTI) (Table 1).One case (0.9%) of mild hydronephrosis was noted in the persistent RUTI group but not related to any clinical parameters.Escherichia coli was the dominant bacteria in both persistent (71%) and reinfection (47%) RUTI in most recently reported urine cultures.CONCLUSIONS: This study reaffirms that upper tract imaging is not indicated for RUTI secondary to reinfection,2 but also not for RUTI due to bacterial persistence, thus questioning the routine practice of upper tract studies in Caucasian post-menopausal women with RUTI.
Source: The Journal of Urology
Authors: Yuefeng Wu, Lauren Rego, Alana Christie, Rebecca Lavelle, Feras Alhalabi, Philippe Zimmern
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4251885498