What risk factors are associated with increased frequency of UTI?
Healthy women and girls have both genetic and behavioral risks for UTI. Genetic variables include polymorphisms of genes for the innate immune response and or being a nonsecretor of the blood group substances so bacteria may adhere more avidly to mucosal surfaces.
For premenopausal women, 75% to 90% of episodes of infection are attributable to sexual intercourse.
Other risk factors include use of spermicides, which disrupt the normal vaginal flora and promote colonization by potential uropathogens, or a new sexual partner within 1 year, which is associated with colonization with new organisms.
A wide variety of functional and structural genitourinary abnormalities contribute to complicated urinary infection, through promoting increased access of bacteria to the bladder or by interfering with normal voiding to allow organisms to persist in the urine. For patients with indwelling devices, the major risk factor for infection is the duration the device remains in situ.
Abnormalities of the Genitourinary Tract Which May Promote Complicated Urinary Tract Infection
|Obstruction||Congenital urethral valvesUreteric strictureUrethral strictureProstate hypertrophyPelvi-calyceal junctionExtrinsic compression|
|Other urologic abnormalities||UrolithiasisBladder diverticulaeCystocelesTumorNeurogenic bladderVesicouretral refluxIleal conduitAugmented bladder|
|Comorbidities||DiabetesNephrocalcinosisMedullary sponge kidneyPolycystic kidneyKidney transplant|
|Indwelling devices||Indwelling catheterUreteric stentNephrostomy tube|