Risk factors for symptomatic urinary tract infection in women with diabetes

OBJECTIVE - Women with diabetes have urinary tract infections (UTIs) more o ften than women without diabetes. The aim of the present multicenter study was to evaluate which clinical characteristics are associated with the deve lopment of a symptomatic UTI during an 18-month follow-up period. RESEARCH DESIGN AND METHODS - Patients with either type 1 or type 2 diabete s who were between 18 and 75 years of age were included. Follow-up results were available for 589 of the 636 women included in this study. All patient s were interviewed, their medical history was noted, and at least one uncon taminated urine culture was collected at the moment of study entry. RESULTS - Of the 589 women, 115 (20%) developed a symptomatic UTI, 96 (83%) of whom were prescribed antimicrobial therapy. A total of 34 women (14%) w ith type 1 diabetes developed a UTI. The most important risk factor for the se women was sexual intercourse during the week before entry into the study (44% without vs. 53% with sexual intercourse, relative risk [RR] = 3.0, P = 0.01). A total of 81 (23%) women with type 2 diabetes developed a UTI. Th e most important risk factor for these women was the presence of asymptomat ic bacteriuria (ASB) at baseline (25% without vs. 42% with ASB, RR = 1.65, P = 0.04). CONCLUSIONS - Risk factors for developing a UTI are the presence of ASB for women with type 2 diabetes and sexual intercourse during the week before e ntry into the study for women with type 1 diabetes.