Journal article icon

Journal article

Defining recurrent urinary tract infection and reinfection risk: electronic health record study

Abstract:

Background 
There is limited evidence to support the current standard recurrent urinary tract infection (rUTI) definition of ≥2 UTIs within 6 months or ≥3 within 12 months. Information about reinfection risk after meeting criteria for rUTI may aid decisions on the value of prophylactic approaches.

Aim 
To estimate the risk of subsequent UTI associated with different rUTI definitions.

Design & setting 
Electronic health record study using Infections in Oxfordshire Research Database (IORD, 2008-2019) and the Clinical Practice Research Datalink (CPRD, 2009-2019).

Method 
We identified community-acquired UTIs, separated by 28 days, in non-pregnant women aged 16+years. We created candidate rUTI definitions varying the time window from 3-9 months, and the number of UTIs required to meet the definition from 2-3 episodes. For each definition, we calculated Kaplan-Meier risk estimates of subsequent UTIs within 6 and 12 months after meeting rUTI criteria.

Results 
Of eligible women with at least one UTI, 18% (15,617/84,809) in IORD and 20% (334,487/1,703,088) in CPRD experienced ≥1 rUTI (current definition). The risk of at least two subsequent UTIs within 12 months after meeting the current rUTI definition rose from 17% (IORD) and 16% (CPRD) to 33% (IORD) and 32% (CPRD) under a rUTI definition of ≥3 UTIs within 6 months. Risk of subsequent UTI also increased with age.

Conclusion 
Risk estimates of subsequent UTIs after a rUTI vary according to the definition of rUTI adopted. Estimates provided here could support shared decision making around UTI prophylaxis and stratification of populations included in future rUTI research.

Publication status:
Published
Peer review status:
Peer reviewed

Actions

Access Document

Publisher copy:
10.3399/BJGPO.2025.0239

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0002-0660-2171
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0002-9928-8934
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0002-0946-742X
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author


More from this funder
Funder identifier:
https://ror.org/015ah0c92
Grant:
200915


Publisher:
Royal College of General Practitioners
Journal:
British Journal of General Practice Open More from this journal
Article number:
0239
Publication date:
2026-02-03
Acceptance date:
2025-11-11
DOI:
EISSN:
2398-3795


Language:
English
Keywords:
Pubs id:
2324449
Local pid:
pubs:2324449
Deposit date:
2025-11-12
ARK identifier:

Terms of use


Views and Downloads






If you are the owner of this record, you can report an update to it here: Report update to this record

TO TOP