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Cited by 125Urinary Tract Infections ManagementEscherichia coli research studiesReproductive tract infections research

Prospective Cohort Study of Microbial and Inflammatory Events Immediately Preceding Escherichia coli Recurrent Urinary Tract Infection in Women

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Czaja, C. A., Stamm, W. E., Stapleton, A. E., Roberts, P. L., Hawn, T. R., Scholes, D., Samadpour, M., Hultgren, S. J. +1 more·2009·The Journal of Infectious Diseases
DOI 10.1086/600385PMC PMC3674869
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Abstract

BACKGROUND: A prospective cohort study was conducted to characterize the temporal sequence of microbial and inflammatory events immediately preceding Escherichia coli recurrent urinary tract infection (rUTI). METHODS: Women with acute cystitis and a history of UTI within the previous year self-collected periurethral and urine samples daily and recorded measurements of urine leukocyte esterase, symptoms, and sexual intercourse daily for 3 months. rUTI strains were characterized by pulsed-field gel electrophoresis and genomic virulence profiling. Urinary cytokine levels were measured. RESULTS: There were 38 E. coli rUTIs in 29 of 104 women. The prevalence of periurethral rUTI strain carriage increased from 46% to 90% during the 14 days immediately preceding rUTI, with similar increases in same-strain bacteriuria (from 7% to 69%), leukocyte esterase (from 31% to 64%), and symptoms (from 3% to 43%), most notably 2-3 days before rUTI (P<.05 for all comparisons). Intercourse with periurethral carriage of the rUTI strain also increased before rUTI (P=.008). Recurrent UTIs preceded by bacteriuria, pyuria, and symptoms were caused by strains less likely to have P fimbriae than other rUTI strains (P=.002). CONCLUSIONS: Among women with frequent rUTIs, the prevalences of periurethral rUTI strain carriage, bacteriuria, pyuria, and intercourse dramatically increase over the days preceding rUTI. A better understanding of the pathogenesis of rUTI will lead to better prevention strategies.

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Authors
Czaja, C. A., Stamm, W. E., Stapleton, A. E., Roberts, P. L., Hawn, T. R., Scholes, D., Samadpour, M., Hultgren, S. J., & Hooton, T. M.
Affiliations
  • University of Washington (US)
  • Group Health Cooperative (US)
  • Washington University in St. Louis (US)
  • University of Miami (US)
Corresponding author
Czaja, C. A.
ORCID
Venue
The Journal of Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2009-08-15
Volume
200
Issue
4
Pages
528-536
ISSN
  • 0022-1899 (ISSN-L)
  • 1537-6613
DOI
10.1086/600385
PMC
PMC3674869
OpenAlex
W2104948245
Cited by
125
References
2
Citations by year
2026: 5 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 12 · 2019: 5 · 2018: 8 · 2017: 9 · 2016: 12 · 2015: 6 · 2014: 9 · 2013: 11 · 2012: 10
FWCI
4.44
Type
journal article
Language
en
Open access
Locations
  • The Journal of Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of Minnesota
  • University of Washington
  • National Institutes of Health
  • National Institute of Diabetes and Digestive and Kidney Diseases (P01DK053369, P50DK064540, P50 AR 049475, R01DK062863, R01DK070906)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (P50-AR049475)
Topics
  • Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords
recurrent urinary tract infection, Escherichia coli, women, bacteriuria, pyuria, leukocyte esterase, sexual intercourse, P fimbriae, urinary cytokines, cystitis, virulence profiling, pathogenesis
MeSH terms
Adolescent, Adult, Escherichia coli Infections, Female, Humans, Inflammation, Middle Aged, Recurrence, Risk Factors, Specimen Handling, Urinary Tract Infections, Cohort Studies, Young Adult

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