Evaluation of Behavioral and Susceptibility Patterns in Premenopausal Women with Recurrent Urinary Tract Infections: A Case Control Study.

Recurrent urinary tract infections (UTI) are a major source of morbidity and healthcare costs. Risk factors associated with recurrence rates in premenopausal women can be attributed to patient lifestyle behavior. The aim of this study was to assess hygienic risk factors, determine pathogen distribution, and susceptibility patterns in premenopausal women with recurrent UTI. This was case-control study in which a face-to-face interview was conducted to obtain information from premenopausal women with recurrent UTI. Microbiology cultures and susceptibility results were obtained to analyze pathogen distribution and resistance. In this study, 214 cases and 230 controls were compared and the following practices were associated with increased risk of recurrent UTI in multivariable analysis: washing genitals from back to front (OR 1.64 [95% CI 1.05-2.56]), not voiding within 15 min after intercourse (OR 2.81 [95% CI 1.72-4.66]), not drinking water after intercourse (OR 1.69 [95% CI 1.12-2.58]), using any soap to clean after urination (OR 2.11 [95% CI 1.42-3.17]). Escherichia coli were the most prevalent pathogens isolated (66.4%), followed by Klebsiella spp. (12.6%), Pseudomonas aeruginosa (12.1%), and Proteus spp., (6.6%). This study identified several modifiable sexual and hygienic practices associated with recurrent UTI in premenopausal women. Continuous surveillance of antimicrobial susceptibility patterns is important to overcome resistance.