Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections

Urinary tract infections (UTIs) are among the most frequent community-acquired infections worldwide. Escherichia coli is the most common UTI pathogen although underlying host factors such as patients’ age and gender may influence prevalence of causative agents. In this study, 61 273 consecutive urin...

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Main Authors: Enrico Magliano, Vittorio Grazioli, Loredana Deflorio, Antonia Isabella Leuci, Roberto Mattina, Paolo Romano, Clementina Elvezia Cocuzza
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1100/2012/349597
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author Enrico Magliano
Vittorio Grazioli
Loredana Deflorio
Antonia Isabella Leuci
Roberto Mattina
Paolo Romano
Clementina Elvezia Cocuzza
author_facet Enrico Magliano
Vittorio Grazioli
Loredana Deflorio
Antonia Isabella Leuci
Roberto Mattina
Paolo Romano
Clementina Elvezia Cocuzza
author_sort Enrico Magliano
collection DOAJ
description Urinary tract infections (UTIs) are among the most frequent community-acquired infections worldwide. Escherichia coli is the most common UTI pathogen although underlying host factors such as patients’ age and gender may influence prevalence of causative agents. In this study, 61 273 consecutive urine samples received over a 22-month period from outpatients clinics of an urban area of north Italy underwent microbiological culture with subsequent bacterial identification and antimicrobial susceptibility testing of positive samples. A total of 13 820 uropathogens were isolated and their prevalence analyzed according to patient’s gender and age group. Overall Escherichia coli accounted for 67.6% of all isolates, followed by Klebsiella pneumoniae (8.8%), Enterococcus faecalis (6.3%), Proteus mirabilis (5.2%), and Pseudomonas aeruginosa (2.5%). Data stratification according to both age and gender showed E. coli isolation rates to be lower in both males aged ≥60 years (52.2%), E. faecalis and P. aeruginosa being more prevalent in this group (11.6% and 7.8%, resp.), as well as in those aged ≤14 years (51.3%) in whom P. mirabilis prevalence was found to be as high as 21.2%. Streptococcus agalactiae overall prevalence was found to be 2.3% although it was shown to occur most frequently in women aged between 15 and 59 years (4.1%). Susceptibility of E. coli to oral antimicrobial agents was demonstrated to be as follows: fosfomycin (72.9%), trimethoprim/sulfamethoxazole (72.9%), ciprofloxacin (76.8%), ampicillin (48.0%), and amoxicillin/clavulanate (77.5%). In conclusion, both patients’ age and gender are significant factors in determining UTIs etiology; they can increase accuracy in defining the causative uropathogen as well as providing useful guidance to empiric treatment.
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spelling doaj-art-27b7ad95bb9a4db1a27ec5f7a15bbefd2025-08-20T02:04:20ZengWileyThe Scientific World Journal1537-744X2012-01-01201210.1100/2012/349597349597Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract InfectionsEnrico Magliano0Vittorio Grazioli1Loredana Deflorio2Antonia Isabella Leuci3Roberto Mattina4Paolo Romano5Clementina Elvezia Cocuzza6Bacteriological Laboratory, Centro Diagnostico Italiano, Via Saint Bon 20, 20147 Milan, ItalyBacteriological Laboratory, Centro Diagnostico Italiano, Via Saint Bon 20, 20147 Milan, ItalyBacteriological Laboratory, Centro Diagnostico Italiano, Via Saint Bon 20, 20147 Milan, ItalyBacteriological Laboratory, Centro Diagnostico Italiano, Via Saint Bon 20, 20147 Milan, ItalyDepartment of Public Health, Microbiology and Virology, University of Milan, Via Pascal 36, 20166 Milan, ItalyDepartment of Public Health, Microbiology and Virology, University of Milan, Via Pascal 36, 20166 Milan, ItalyDepartment of Clinical and Preventive Medicine, University of Milano-Bicocca, Via Cadore 48, 20052 Monza, ItalyUrinary tract infections (UTIs) are among the most frequent community-acquired infections worldwide. Escherichia coli is the most common UTI pathogen although underlying host factors such as patients’ age and gender may influence prevalence of causative agents. In this study, 61 273 consecutive urine samples received over a 22-month period from outpatients clinics of an urban area of north Italy underwent microbiological culture with subsequent bacterial identification and antimicrobial susceptibility testing of positive samples. A total of 13 820 uropathogens were isolated and their prevalence analyzed according to patient’s gender and age group. Overall Escherichia coli accounted for 67.6% of all isolates, followed by Klebsiella pneumoniae (8.8%), Enterococcus faecalis (6.3%), Proteus mirabilis (5.2%), and Pseudomonas aeruginosa (2.5%). Data stratification according to both age and gender showed E. coli isolation rates to be lower in both males aged ≥60 years (52.2%), E. faecalis and P. aeruginosa being more prevalent in this group (11.6% and 7.8%, resp.), as well as in those aged ≤14 years (51.3%) in whom P. mirabilis prevalence was found to be as high as 21.2%. Streptococcus agalactiae overall prevalence was found to be 2.3% although it was shown to occur most frequently in women aged between 15 and 59 years (4.1%). Susceptibility of E. coli to oral antimicrobial agents was demonstrated to be as follows: fosfomycin (72.9%), trimethoprim/sulfamethoxazole (72.9%), ciprofloxacin (76.8%), ampicillin (48.0%), and amoxicillin/clavulanate (77.5%). In conclusion, both patients’ age and gender are significant factors in determining UTIs etiology; they can increase accuracy in defining the causative uropathogen as well as providing useful guidance to empiric treatment.http://dx.doi.org/10.1100/2012/349597
spellingShingle Enrico Magliano
Vittorio Grazioli
Loredana Deflorio
Antonia Isabella Leuci
Roberto Mattina
Paolo Romano
Clementina Elvezia Cocuzza
Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections
The Scientific World Journal
title Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections
title_full Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections
title_fullStr Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections
title_full_unstemmed Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections
title_short Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections
title_sort gender and age dependent etiology of community acquired urinary tract infections
url http://dx.doi.org/10.1100/2012/349597
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