Impact of Menopausal Status on Uropathogen Prevalence and Antimicrobial Resistance Profiles
Kristen Venuti1, Camila Cabrera1, Linda S Burkett2
1From the Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Womens Hospital.
Objectives:
The unique factors associated with urinary tract infections (UTIs) in postmenopausal (PMP) women have been significantly less investigated as compared with premenopausal (PreMP) women. Our objective was to compare the prevalence of uropathogens and antibiotic resistance patterns between PreMP and PMP women with UTIs.
Methods:
This was a cross-sectional analysis of PreMP and PMP women treated for a UTI in a urogynecologic practice between November 2016 and November 2017. Diagnostic criteria for UTI included lower urinary tract symptoms and a positive urine culture. Our primary outcome was proportion of non-Escherichia coli UTIs between groups.
Results:
We had 370 women with mean (SD) age of 66.7 (12.8) years and body mass index of 29.1 (7.1) kg/m2. Most women were PMP (88.6%). Postmenopausal status did not increase the proportion of non-E. coli UTI (42.7% PMP vs 33.3% PreMP, P = 0.25) or decrease the proportion of pansensitive UTI (36.0% PMP vs 42.9% PreMP, P = 0.38).In multivariable analysis, women with a history of rUTI were at higher odds of having a non-E. coli UTI (adjusted odds ratio, 1.93; 95% confidence interval, 1.21-3.08; P = 0.01) and at lower odds of pansensitive urine culture (adjusted odds ratio, 0.37; 95% confidence interval, 0.22-0.63; P < 0.01) as compared with those without rUTI, when controlling for confounders. Postmenopausal women with a history of rUTI had the highest proportion of non-E. coli UTIs (51.1%, P < 0.01) and lowest proportion of pansensitive uropathogens (29.1%, P < 0.01) as compared with other PMP women and PreMP without a history of rUTI.
Conclusions:
In a urogynecologic population, a history of rUTI, more than menopausal status, significantly impacted the prevalence of specific uropathogens and resistant organisms.
Insights
A history of recurrent urinary tract infections (rUTIs), not menopausal status, significantly impacts uropathogen types and antibiotic resistance in women. This finding is crucial for understanding and treating UTIs in different age groups.
Area of Science:
- Urology
- Infectious Diseases
- Women's Health
Background:
- Urinary tract infections (UTIs) are common, but factors influencing uropathogen prevalence and antibiotic resistance in postmenopausal (PMP) women are less understood compared to premenopausal (PreMP) women.
- Investigating these differences is crucial for effective UTI management in aging populations.
Purpose of the Study:
- To compare the prevalence of uropathogens and antibiotic resistance patterns in PMP and PreMP women diagnosed with UTIs.
- To identify key factors, including menopausal status and history of recurrent UTIs (rUTI), associated with specific uropathogen profiles and resistance.
Main Methods:
- A cross-sectional analysis was conducted on 370 women treated for UTI in a urogynecologic practice.
- Data were collected between November 2016 and November 2017, with UTI diagnosis based on symptoms and positive urine culture.
- The primary outcome compared was the proportion of non-Escherichia coli UTIs between premenopausal and postmenopausal groups.
Main Results:
- Postmenopausal status (PMP) did not significantly increase the proportion of non-E. coli UTIs or decrease the proportion of pansensitive UTIs compared to premenopausal (PreMP) women.
- A history of rUTI was significantly associated with a higher likelihood of non-E. coli UTIs (aOR, 1.93) and a lower likelihood of pansensitive urine cultures (aOR, 0.37).
- PMP women with a history of rUTI exhibited the highest rates of non-E. coli UTIs (51.1%) and the lowest rates of pansensitive uropathogens (29.1%).
Conclusions:
- In a urogynecologic patient population, a history of recurrent UTIs is a more significant determinant of uropathogen type and antibiotic resistance than menopausal status.
- These findings highlight the importance of considering UTI history when managing infections, particularly in postmenopausal women.
- Further research into the specific mechanisms driving these associations may lead to improved targeted therapies.
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