Urinary Tract Infections in Hospitalized Inflammatory Bowel Disease Patients: A 10-Year Experience

Background. Cystitis is the most common genitourinary complication in Crohn's disease (CD). We assessed the prevalence of and risk factors for urinary trac

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Laurent Peyrin-Biroulet, MD, PhD

1Inserm, U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Claire Pillot, MD

1Inserm, U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Abderrahim Oussalah, MD

1Inserm, U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Vincent Billioud, MD

1Inserm, U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Nejla Aissa, MD

2Department of Bacteriology, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Mamadou Balde, MD

3Department of Medical Information, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Nicolas Williet, MD

1Inserm, U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Adeline Germain, MD

4Department of Digestive Surgery, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Alain Lozniewski, MD, PhD

2Department of Bacteriology, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Laurent Bresler, MD, PhD

4Department of Digestive Surgery, University Hospital of Nancy, Vandoeuvre-Les-Nancy, France

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Background

Cystitis is the most common genitourinary complication in Crohn's disease (CD). We assessed the prevalence of and risk factors for urinary tract infections (UTI) in inflammatory bowel diseases (IBD).

Methods

Among the 1173 IBD patients of the “Nancy IBD cohort” seen between January 1, 2000 and December 31, 2009, 56 hospitalized patients had 76 documented UTI. Prevalence of UTI in IBD was calculated using rates of UTI among non-IBD patients hospitalized during the same period. The cases were compared to 175 matched IBD patients without UTI hospitalized during the same period to identify risk factors for UTI.

Results

Prevalence of UTI was 4% in IBD patients versus 3.3% in non-IBD patients (P = 0.1). Prevalence of UTI was 4.5% and 2.1% in ulcerative colitis (UC) and CD patients, respectively (P = 0.6). Risk factors for UTI in CD patients were perianal disease (odds ratio [OR] = 2.28, 95% confidence interval [CI], 1.06–4.89; P = 0.04) and colonic disease (OR = 2.42, 95% CI, 1.05–5.58; P = 0.04). Male gender (OR = 0.38, 95% CI, 0.17–0.85, P = 0.02) and noncomplicated behavior (OR = 0.26, 95% CI, 0.11–0.60, P = 0.002) were protective factors against UTI in CD. In UC patients, age over 40 years (OR = 9.59, 95% CI, 1.93–47.74; P = 0.006) and disease duration over 11 months (OR = 10.77, 95% CI, 1.68–68.89, P = 0.01) were risk factors for UTI. Male gender was negatively associated with UTI (OR = 0.04, 95% CI, 0.01–0.36, P = 0.00006).

Conclusions

Hospitalized IBD patients are not at increased risk of UTI. Risk factors for UTI include perianal disease and colonic disease in CD and age and longer disease duration in UC.

Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

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