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Ann Intern Med. 2005 Jan 4;142(1):20-7.

Risk factors associated with acute pyelonephritis in healthy women.

Author information

1
Group Health Cooperative and University of Washington, Seattle, Washington, USA. scholes.d@ghc.org

Abstract

BACKGROUND:

Although most cases of acute pyelonephritis occur in otherwise healthy women, data on risk factors for this condition are lacking.

OBJECTIVE:

To evaluate infection characteristics, incidence, and risk factors associated with acute pyelonephritis in a sample of women.

DESIGN:

Population-based case-control study.

SETTING:

Group Health Cooperative, a prepaid health plan in Washington.

PARTICIPANTS:

788 nonpregnant women, 18 to 49 years of age. Case-patients (n = 242) were women with pyelonephritis who were identified from computerized databases. Controls were 546 similar-age women with no pyelonephritis diagnosis in the previous 5 years who were randomly selected from enrollment databases. Response rates for case-patients and controls were 73% and 64%, respectively.

MEASUREMENTS:

Characteristics of infection and potential risk factors for pyelonephritis, ascertained through computer-assisted telephone interview and computerized databases.

RESULTS:

7% of case-patients were hospitalized. Escherichia coli was the infecting pathogen in 85% of cases. In multivariable models, factors associated with pyelonephritis risk were frequency of sexual intercourse in the previous 30 days (odds ratio, 5.6 [95% CI, 2.8 to 11.0] for > or =3 times per week), recent urinary tract infection (UTI) (odds ratio, 4.4 [CI, 2.8 to 7.1]), diabetes (odds ratio, 4.1 [CI, 1.6 to 10.9]), recent incontinence (odds ratio, 3.9 [CI. 2.6 to 5.9]), new sexual partner in the previous year (odds ratio, 2.2 [CI, 1.4 to 3.6]), recent spermicide use (odds ratio, 1.7 [CI, 1.1 to 2.8]), and UTI history in the participant's mother (odds ratio, 1.6 [CI, 1.1 to 2.5]). Risk factors for selected subgroups (patients < or = 30 years of age, patients > 30 years of age, patients with no UTI history, and inpatients) were also evaluated.

LIMITATIONS:

Potential recall bias, reliance on automated case definition criteria, and limited data on diabetes and incontinence variables.

CONCLUSIONS:

Few nonpregnant, community-dwelling women younger than 50 years of age with pyelonephritis are hospitalized. As with cystitis in reproductive-age women, sexual behaviors and patient and family history of UTI are associated with increased pyelonephritis risk. Diabetes and incontinence also seem to independently increase the risk for pyelonephritis.

PMID:
15630106
PMCID:
PMC3722605
[Indexed for MEDLINE]
Free PMC Article

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