Travelers’ Diarrhea Significantly Increases Urinary Tract Infection Risk

Urinary tract infections (UTIs) occur more frequently in travelers to low- and middle-income countries and travelers’ diarrhea was a significant risk factor, according to results of a study in Travel Medicine and Infectious Disease.

This analysis included adults from Helsinki, Finland who were enrolled between December 2008 and February 2010 prior to traveling outside the country. The researchers used multivariable analyses to determine associations between UTI risk and international travel, and the incidence rate (IR) of UTI was calculated separately by participant sex.

Among patients included in the analysis, the median age was 38 (range, 0-77) years, and 63.1% were women. Of the destinations, 88.1% of participants traveled to the tropics (Western and Middle Africa, Southeast Asia, Eastern Africa, South Asia, Latin America, and the Caribbean). The median duration of travel was 15 (range, 4-159) days.

Among men (n=191) vs women (n=326), the researchers found that cystitis occurred more frequently in women (4% vs 1%; odds ratio [OR], 3.6; 95% CI, 0.8-33.6; P =.118). The rate of UTIs also was significantly increased among women (IR, 0.62; 95% CI, 0.36-1.1) vs men (IR, 0.18; 95% CI, 0.04-0.71).

After stratification by sex and age, UTI diagnoses were the most common among younger adults and the least common among those aged between 55 and 64 years. However, the difference in UTI incidence between these groups was not significant (OR, 1.0; 95% CI, 1.0-1.0, P =.717), including when the analysis was limited to only women (OR, 1.0; 95% CI, 1.0-1.0; P =.775).

The occurrence of diarrhea prior to or shortly after travel was associated with an increased risk for UTI for all participants (OR, 9.2; 95% CI, 1.5±∞; P =.011), as well as among only women (OR, 7.5; 95% CI, 1.2±∞; P =.028).

Limitations of this study included the inability to conduct subgroup analyses on UTI incidence by age group and destination due to the small number of UTI diagnoses, and the lack of data on urinary pathogens.

“Our findings further highlight the importance of pre-travel advice to avoid health problems while abroad,” the researchers concluded.

Disclosure: One authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures

Reference

Patjas A, Kantele A. International travel and travelers’ diarrhea—increased risk of urinary tract infection. Travel Med Infect Dis. Published online April 18, 2022. doi: 10.1016/j.tmaid.2022.102331