What is the epidemiology and burden of urinary tract infections (UTIs) in a given location?

UTI Epidemiology and Burden

Urinary tract infections represent one of the most common bacterial infections globally, affecting over 150 million people annually in community settings alone, with women experiencing 30 times higher incidence than men under age 50. 1, 2

Global Incidence and Prevalence

Community-Acquired UTIs

• Annual incidence is 12.1% in women and 3% in men, making UTIs among the most frequent infections in clinical practice worldwide 3
• Community-associated UTI prevalence stands at 0.7% globally 4
• Nearly 1 in 3 women will experience at least one UTI requiring antimicrobial therapy by age 24, and almost half of all women will have at least one UTI during their lifetime 5
• Recurrent UTIs occur in 20-30% of women, defined as three infections in one year or two in six months 3

Healthcare-Associated UTIs

• Healthcare-associated UTI frequency among healthcare-associated infections is 12.9% in the United States, 19.6% in Europe, and 24% in developing countries 4
• In urology departments specifically, the prevalence reaches 5.1% 4
• The prevalence of HAUTIs ranges between 1.4% and 5.1%, with the majority being catheter-related 1
• Catheter-associated UTI is the most common nosocomial infection, accounting for more than 1 million cases in hospitals and nursing homes 5

Healthcare Utilization Burden

Outpatient and Emergency Settings

• UTIs account for more than 10 million outpatient visits annually 3
• More than 3 million emergency department visits occur each year for UTIs 3
• UTIs result in approximately 100,000 hospitalizations annually 5
• In noninstitutionalized elderly populations, UTIs are the second most common form of infection, accounting for nearly 25% of all infections 5

Economic Impact

• The estimated annual cost of community-acquired UTI is approximately $1.6 billion 5
• Complicated UTIs in particular constitute a huge burden on healthcare systems as a frequent reason for hospitalization 1

High-Risk Populations

Specific subpopulations face substantially elevated UTI risk and include 5:

• Infants
• Pregnant women
• Elderly patients
• Patients with spinal cord injuries and/or catheters
• Patients with diabetes or multiple sclerosis
• Patients with AIDS/HIV
• Patients with underlying urologic abnormalities

Microbiology and Resistance Patterns

Predominant Pathogen

• Escherichia coli remains the most common pathogen in both community-acquired uncomplicated UTIs and across all UTI types 3, 2

Antibiotic Resistance

• Resistance rates to common antibiotics depend heavily on geographical location 4
• The lowest observed resistance globally is for fosfomycin (0-2.9%), nitrofurantoin (0-4.4%), and mecillinam (0-4%) 4
• In healthcare-associated UTIs, resistance to almost all antibiotics exceeds 20% with significant geographical variation 4

Clinical Complications and Morbidity

While acute uncomplicated UTI in nonobstructed, nonpregnant female adults is generally benign, serious complications occur in specific populations 5:

• UTI elevates the risk of pyelonephritis, premature delivery, and fetal mortality among pregnant women 5
• Associated with impaired renal function and end-stage renal disease among pediatric patients 5
• Significant complications of pyelonephritis include sepsis or septic shock, obstructive pyelonephritis, emphysematous pyelonephritis, perinephric abscess, and kidney transplant rejection 3

Quality of Life Impact

• UTIs create both clinical and economic burdens on healthcare systems while significantly affecting quality of life determinants 1
• The frequency and burden are likely higher than available data suggest because UTIs are not among mandatory diseases requiring notification 1