Epidemiology of urinary tract infections: incidence, morbidity, and economic costs
Section snippets
Symptomatic UTI
Symptomatic UTI is very common among sexually active women15 and far more common among women than men. An estimated 1 in 3 women will have at least 1 UTI diagnosed by a clinician requiring antimicrobial treatment by the age of 24 years,16 and 40% to 50% of women will experience at least 1 UTI during their lifetime16, 17, 18, 19(Figure 2). A recent random digit dialing survey of 2,000 women in the United States found that 10.8% of women >18 years reported at least 1 presumed UTI during the
Pediatrics
Approximately 3% of prepubertal girls and 1% of prepubertal boys are diagnosed with UTI5(Table 3). Many girls who do not undergo radiographic evaluation after an initial UTI experience a recurrence within 1 year,5 and girls who experience recurrent UTI are at increased risk of renal scarring,46 which then increases their risk of progressive renal disease in adulthood.47 A retrospective study recently found that 35% of boys and 32% of girls who had their first UTI at <1 year of age contracted a
Uncomplicated UTI
Acute uncomplicated UTI (cystitis) in the nonobstructed adult, nonpregnant woman is believed to be a benign illness with no long-term medical sequelae. To date, however, there are no large-scale prospective studies verifying this assumption. There are data highlighting significant short-term ramifications of acute uncomplicated UTI. Research on college women found that UTI resulted in 6.1 symptomatic days, 2.4 days of restricted activity, and 0.4 days of bed rest.30 Within 3 to 4 months of an
Financial implications of UTI
The financial implications of UTI are enormous, predominantly a result of the high incidence of UTI. Direct costs include the costs of outpatient doctor visits, antimicrobial prescriptions, and hospitalization expenses, as well as the nonmedical costs associated with travel, sick days, and morbidity. The indirect costs of lost output must also be considered. Although acute uncomplicated UTI is considered to be a benign condition with minimal long-term sequelae, it is associated with significant
Summary
UTI is the most common bacterial infection. It is generally associated with minimal morbidity except among specific subpopulations. However, there is a significant absence of data regarding its accurate incidence, factors that increase susceptibility to UTI, and the long-term medical sequelae of UTI.
There are many areas for future investigational effort. There is a need for accurate data regarding the incidence of symptomatic UTI and pyelonephritis among all populations. There is an increasing
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