International travel and travelers' diarrhea - Increased risk of urinary tract infection

Anu Patjas; Anu Kantele

doi:10.1016/j.tmaid.2022.102331

International travel and travelers' diarrhea - Increased risk of urinary tract infection

Travel Med Infect Dis. 2022 Jul-Aug:48:102331. doi: 10.1016/j.tmaid.2022.102331. Epub 2022 Apr 18.

Authors

Anu Patjas¹, Anu Kantele²

Affiliations

¹ Meilahti Vaccine Research Center, MeVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, P.O. Box 700, FI-00029 HUS, Helsinki, Finland; Human Microbiome Research Unit, University of Helsinki, Finland; Travel Clinic, Aava Medical Center, Annankatu 32, FI-00100 Helsinki, Finland; Center of Excellence in Antimicrobial Resistance Research, University of Helsinki, Finland.
² Meilahti Vaccine Research Center, MeVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, P.O. Box 700, FI-00029 HUS, Helsinki, Finland; Human Microbiome Research Unit, University of Helsinki, Finland; Travel Clinic, Aava Medical Center, Annankatu 32, FI-00100 Helsinki, Finland; Center of Excellence in Antimicrobial Resistance Research, University of Helsinki, Finland. Electronic address: anu.kantele@hus.fi.

PMID: 35447322
DOI: 10.1016/j.tmaid.2022.102331

Abstract

Background: Urinary tract infections (UTIs) rank among the most common infections encountered in health care, with an annual incidence of 12% for women. Despite the vast numbers of international travels (over 1.5 billion annually), no prospective studies have had primary focus on UTIs during travel.

Methods: We recruited in 2008-17 international travelers who all filled out pre- and post-travel questionnaires. Incidence rates of UTI were calculated separately for both sexes. Multivariable analyses were conducted to identify risk factors for UTI during travel.

Results: In total 15/517 (2,9%) travelers acquired UTI during travel, yielding an annual incidence of 62% for female and 18% for male travelers. Travelers' diarrhea (TD) was identified as a factor predisposing to UTI (OR 9.2, 95% CI 1.5-+∞, p = 0.011); all UTI cases were recorded by travelers with TD.

Conclusions: To our knowledge, this is the first prospective study with a primary focus on UTI during travel. Our data reveal that among travelers the incidence of UTI far exceeds that reported for the general population. TD was identified as a major risk factor for the infection. Our results suggest TD prevention as a means of also preventing UTI during travel.

Keywords: Cystitis; Pyelonephritis; Travelers' diarrhea; UTI; Urinary tract infections.

MeSH terms

Diarrhea / prevention & control
Female
Humans
Male
Prospective Studies
Risk Factors
Travel*
Urinary Tract Infections* / epidemiology