Qualitative Analysis of a Twitter-Disseminated Survey Reveals New Patient Perspectives on the Impact of Urinary Tract Infection

Valentine-King, Marissa; Laytner, Lindsey; Hines-Munson, Casey; Olmeda, Kiara; Trautner, Barbara W.; Justice, Sheryl S.; Ching, Christina B.; Grigoryan, Larissa

doi:10.3390/antibiotics11121687

Cited by 9 publications

(12 citation statements)

References 35 publications

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“…14 Women identified UTIs with the word "bother," 15 with a Twitter-disseminated survey describing a drastic impact on physical and mental health leading to severe limitations in life activities. 16 Recurrent UTIs in people with n ORIGINAL RESEARCH spinal cord injuries demonstrated distress from perceptions of it as stigmatizing with fear of antibiotic reliance, seeking alternative prevention and management strategies, and causing barriers to social participation with adverse effects on quality of life. 17 In addition, women with at least 1 uncomplicated UTI expressed negative emotions with activities of daily life, relationships, treatment and management approaches, treatment failure, and recurrent uncomplicated UTIs.…”

Section: Discussionmentioning

confidence: 99%

“…Diverse symptom descriptions were typical for women with cystitis, 12 with recurrent UTIs in older women affecting physical and psychological health, restricting daily life, increasing dependence on access to relief, and receiving inadequate care 13 with fears that their symptoms may indicate something more serious than a UTI 14 . Women identified UTIs with the word “bother,” 15 with a Twitter-disseminated survey describing a drastic impact on physical and mental health leading to severe limitations in life activities 16 . Recurrent UTIs in people with spinal cord injuries demonstrated distress from perceptions of it as stigmatizing with fear of antibiotic reliance, seeking alternative prevention and management strategies, and causing barriers to social participation with adverse effects on quality of life 17 .…”

Section: Discussionmentioning

confidence: 99%

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Women’s Experiences of Urinary Tract Infections and Impact on Life: An Exploratory Qualitative Study

Krishnaswamy

Middleton

Hagen

et al. 2023

UROGC

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Importance Despite high incidences of urinary tract infections (UTIs), little is known about how bothersome symptoms are and the effects on women's life and sexual activity, leaving a gap in our understanding of the physical and emotional effects of UTIs on women. Objectives This initial exploratory and descriptive study analyzes women's experiences of UTI and their perceived impact on quality of life. Study Design Qualitative interviews were undertaken with 23 women who had experienced at least 1 UTI, recruited from different settings—primary care, general gynecology clinics, urogynecology clinics, and online via social media. Data were analyzed thematically. Results Three themes described women's experiences of UTI: Women in all groups reported a wide range of physical symptoms and described the financial and psychological effects of UTIs. These effects seemed worse in women recruited via social media who also reported experiencing strong emotions and worries about close family members. Urinary tract infection support groups were considered useful, with women being grateful for consultations with alternative health practitioners and presuming safety of natural products. Conclusions Having a UTI appeared to affect women in a variety of ways, ranging from having different physical symptoms to being psychologically affected by these symptoms, which affected their quality of life in different ways. This research contributes to the growing evidence on how UTIs affect women, specifically further expanding on the impact on women in a range of settings—in the community and different health care settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Women’s Experiences of Urinary Tract Infections and Impact on Life: An Exploratory Qualitative Study

Krishnaswamy

Middleton

Hagen

et al. 2023

UROGC

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“…6-9 Recurrent UTIs exert negative impacts on several aspects of physical, mental, and sexual health, with a subset of patients experiencing extreme symptoms. 11-14…”

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confidence: 99%

“…[6][7][8][9] Recurrent UTIs exert negative impacts on several aspects of physical, mental, and sexual health, with a subset of patients experiencing extreme symptoms. [11][12][13][14] As recurrent UTIs require repeated courses of antibiotics coupled with prophylactic treatment regimens, this increased exposure places patients at higher risk for developing antimicrobial resistance and treatment failure. 15 Indeed, a Brazilian study conducted among patients seen in the ED or urological office found those with recurrent cystitis or pyelonephritis had significantly higher resistance to 13 antibiotics compared to those with sporadic UTI.…”

mentioning

confidence: 99%

Predicting Antibiotic Susceptibility Among Patients With Recurrent Urinary Tract Infection Using a Prior Culture

Valentine-King,

Trautner,

Zoorob

et al. 2024

Journal of Urology

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Purpose: Recurrent cystitis guidelines recommend relying on a local antibiogram or prior urine culture to guide empirical prescribing, yet little data exist to quantify the predictive value of a prior culture. We constructed a urinary antibiogram and evaluated test metrics (sensitivity, specificity, and Bayes' positive and negative predictive values) of a prior gram-negative organism on predicting subsequent resistance or susceptibility among patients with uncomplicated, recurrent cystitis. Materials and Methods: We performed a retrospective database study of adults with recurrent, uncomplicated cystitis (cystitis occurring 2 times in 6 months or 3 times in 12 months) from urology or primary care clinics between November 1, 2016, and December 31, 2018. We excluded pregnant females, patients with complicated cystitis, or pyelonephritis. Test metrics were calculated between sequential, paired cultures using standard formulas. Results: We included 597 visits from 232 unique patients wherein 310 (51.2%) visits had a urine culture and 165 had gram-negative uropathogens isolated. Patients with gram-negative uropathogens were mostly females (97%), with a median age of 58.5 years. Our antibiogram found 38.0%, 27.9%, and 5.5% of Escherichia coli isolates had resistance to trimethoprim-sulfamethoxazole, ciprofloxacin, and nitrofurantoin, respectively. Prior cultures (within 2 years) had good predictive value for detecting future susceptibility to first-line agents nitrofurantoin (0.85) and trimethoprim-sulfamethoxazole (0.78) and excellent predictive values (0.90) for cefepime, ceftriaxone, cefuroxime, ciprofloxacin, levofloxacin, gentamicin, tobramycin, piperacillin-tazobactam, and imipenem. Conclusions: Considerable antibiotic resistance was detected among E coli isolates in patients with recurrent, uncomplicated cystitis. Using a prior culture as a guide can enhance the probability of selecting an effective empirical agent.

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“…5 A recent twitter survey captured similar themes regarding UTIs in women, including the profound impact on physical and mental health, inadequate treatment and diagnosis, feelings of limited knowledge about pathophysiology, and gaps in research. 7 Due to these experiences and feelings of dissatisfaction, women often seek medical management and insights from alternative sources to medical providers, such as online forums, herbalists, and acupuncturists. 5 Approximately twothirds of women with rUTI wait until they have experienced four UTIs before beginning prophylactic measures.…”

mentioning

confidence: 99%

Recurrent urinary tract infection management and prevention techniques among a population‐based cohort of women

Gleicher,

Sebesta,

Kaufman

et al. 2023

Neurourology and Urodynamics

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IntroductionRecurrent urinary tract infection (rUTI), defined as three or more UTIs in 12 months, has psychological, physical, and financial burden. Many women with rUTI are not satisfied with care and report only starting preventative measures after several infections. The goal of this study is to elucidate current UTI management trends and the implementation of UTI prevention strategies.MethodsA web‐based study was sent to a national sample of adult women enrolled in ResearchMatch.org. Women were recruited to participate if they had a self‐reported UTI in the past 12 months.ResultsOf the 755 subjects, nearly 30% reported rUTI. Among women with rUTI, more than 50% reported being peri‐ or postmenopausal, and two‐thirds reported vaginal symptoms. 15.8% of women with rUTI reported dissatisfaction with care versus 7.9% of women without rUTI. Most women see their primary care physician for UTI management and only 26% of women with rUTI follow with a urologist. More than 65% of women increase their fluid intake, wipe from front to back, and urinate after sexual activity to prevent UTIs. Significantly more women with rUTI use transvaginal estrogen, cranberry extract, and low‐dose prophylactic antibiotics. These interventions appear to be driven by urologists.ConclusionMost women who have had a UTI in the last 12 months implement lifestyle changes to prevent future infections. Most women see their PCP for UTI management and women with rUTI are twice as likely to report dissatisfaction with care. Despite urologists optimizing medical rUTI prevention, they appear to be underutilized.

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Qualitative Analysis of a Twitter-Disseminated Survey Reveals New Patient Perspectives on the Impact of Urinary Tract Infection

Cited by 9 publications

References 35 publications

Women’s Experiences of Urinary Tract Infections and Impact on Life: An Exploratory Qualitative Study

Women’s Experiences of Urinary Tract Infections and Impact on Life: An Exploratory Qualitative Study

Predicting Antibiotic Susceptibility Among Patients With Recurrent Urinary Tract Infection Using a Prior Culture

Recurrent urinary tract infection management and prevention techniques among a population‐based cohort of women

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