Urinary manifestations in African American and Caucasian inflammatory bowel disease patients: a retrospective cohort study

Abstract

Background Inflammatory bowel diseases (IBD), like ulcerative colitis (UC) and Crohn’s disease (CD), are associated with urinary extra-intestinal manifestations, like urolithiasis and uncomplicated urinary tract infections (UTIs). The literature reviewed for this study identifies an increased association of CD and urolithiasis against the general population as well as UC. Furthermore, the rates in which urinary comorbidities manifest have not been well characterized in cross-race analyses. The purpose of this study is to establish the prevalence of common urinary extra-intestinal manifestations in CD and UC and to further determine at what rate these affect the African American and Caucasian populations. Methodology This is a retrospective cohort study using de-identified data collected from a research data base that included 6 integrated facilities associated with one tertiary healthcare center from 2012 to 2019. The electronic chart records for 3104 Caucasian and African American IBD patients were reviewed for frequency of urolithiasis and uncomplicated UTI via diagnosed ICD-10 codes. Comparison between data groups was made using multivariate regressions, t-tests, and chi square tests. Results Our study included 3104 patients of which 59% were female, 38% were African American, and 43% were diagnosed with UC. Similar proportions of UC and CD diagnosed patients developed urolithiasis (6.0% vs 6.7%, p = 0.46), as well as uncomplicated UTIs (15.6% vs. 14.9%, p = 0.56). Similar proportions of African American and Caucasian patients developed urolithiasis (5.4% vs 7.0%, p = 0.09), but a higher proportion of African Americans developed uncomplicated UTIs (19.4% vs 12.6%, p ≤ 0.001). Conclusion We found similar rates of urolithiasis formation in both UC and CD in this study. Furthermore, these rates were not significantly different between African American and Caucasian IBD populations. This suggests that UC patients have an elevated risk of urolithiasis formation as those patients with CD. Additionally, African Americans with IBD have a higher frequency of uncomplicated UTI as compared to their Caucasian counterparts.

Emergence of Antimicrobial Resistance in Uropathogens in Butembo, Democratic Republic of Congo: A 5 Years Retrospective Study

“…Thus, medical orders and self-medication use of antibiotics to treat UTIs are mostly observed in sexually active individuals, which resulted in recurrent infection and the development of drug-resistant clones [30]. The current study showed that most patients belong to the age group 16-50 (including male and female), similar nding has been reported in South Africa [31] and even in America [32]. However, in contrast to our study, Canadian data revealed an increase in UTI among older patients [33].…”

“…We have linked S. aureus to UTI in males reported rst time but a high prevalence of S. aureus UTI in females has been reported previously [37]. In contrast, some reports mentioned that Escherichia coli is the key causative agent in UTI, reports from another part of the Democratic Republic of Congo as well as USA, Africa and Ethiopia but our study mentioned the second most important bacteria is Escherichia coli about 12% [20,32,38]. In our study second most, important bacteria are Escherichia coli followed by the Stepatocuccus spp, Klebsiella spp., Bacillus spp., Edwardsiella spp., Leclercia spp., Pneumatera spp., Budvicia spp., Cedecea spp.…”

Phylogrouping and characterization of Escherichia coli isolated from colonic biopsies and fecal samples of patients with flare of inflammatory bowel disease in Iran

“…Moreover, IBD patients with anorectal complications, which include perianal abscesses and anal fistulas, appear to have an increased risk for UTIs. It could be explained that in these patients anorectal complications could lead to bacterial translocation from the perineum to the bladder ( 53 , 54 ). Accordingly, the overgrowth of E. coli strains with extraintestinal virulence capacity in IBD patients could act as a risk factor for UTI development.…”

Urolithiasis in patients with inflammatory bowel disease: A systematic review and meta-analysis of 13,339,065 individuals

“…Regarding CD, the prevalence of urolithiasis was 7.1%, 95% CI (3.6%-13.6%), nephrolithiasis 4.6%, 95% CI (3.6%-5.8%), and both 11.9%, 95% CI (8.4%-16.6%). Based on [29,33,35,36,38,39] showed that there was a significant association between developing urolithiasis and the disease duration of IBD (OR = 1.03, 95% CI: 3.…”