Urinary tract infections in hospitalized inflammatory bowel disease patients: a 10-year experience

Background: Cystitis is the most common genitourinary complication in Crohn's disease (CD). We assessed the prevalence of and risk factors for urinary tract infections (UTI) in inflammatory bowel diseases (IBD).

Methods: Among the 1173 IBD patients of the "Nancy IBD cohort" seen between January 1, 2000 and December 31, 2009, 56 hospitalized patients had 76 documented UTI. Prevalence of UTI in IBD was calculated using rates of UTI among non-IBD patients hospitalized during the same period. The cases were compared to 175 matched IBD patients without UTI hospitalized during the same period to identify risk factors for UTI.

Results: Prevalence of UTI was 4% in IBD patients versus 3.3% in non-IBD patients (P = 0.1). Prevalence of UTI was 4.5% and 2.1% in ulcerative colitis (UC) and CD patients, respectively (P = 0.6). Risk factors for UTI in CD patients were perianal disease (odds ratio [OR] = 2.28, 95% confidence interval [CI], 1.06-4.89; P = 0.04) and colonic disease (OR = 2.42, 95% CI, 1.05-5.58; P = 0.04). Male gender (OR = 0.38, 95% CI, 0.17-0.85, P = 0.02) and noncomplicated behavior (OR = 0.26, 95% CI, 0.11-0.60, P = 0.002) were protective factors against UTI in CD. In UC patients, age over 40 years (OR = 9.59, 95% CI, 1.93-47.74; P = 0.006) and disease duration over 11 months (OR = 10.77, 95% CI, 1.68-68.89, P = 0.01) were risk factors for UTI. Male gender was negatively associated with UTI (OR = 0.04, 95% CI, 0.01-0.36, P = 0.00006).

Conclusions: Hospitalized IBD patients are not at increased risk of UTI. Risk factors for UTI include perianal disease and colonic disease in CD and age and longer disease duration in UC.