Obesity and a Febrile Urinary Tract Infection: Dual Burden for Young Children?

Risk factors for postoperative urethral diverticulum following hypospadias repair with disconnection of the urethral plate

BACKGROUND

Urethral diverticulum (UD) may arise subsequent to hypospadias repair, potentially causing issues such as stone formation, frequent urination, urinary tract infections, urine dripping, and hematuria. We reviewed our previous experiences regarding hypospadias complications to identify the relevant factors affecting the occurrence of UD after hypospadias surgery and adjust management strategies accordingly.

METHODS

A retrospective analysis was performed on the clinical data of 159 pediatric patients who underwent urethroplasty with disconnection of the urethral plate (DUP) in our department from January 2020 to December 2022. The collected information included patient demographics such as age, weight, Body Mass Index (BMI), Hemoglobin (Hb), Hematocrit (HCT), Albumin (ALB), Prealbumin (PALB), Procalcitonin (PCT), the employed surgical methods, whether the procedure was performed in stages, glans width, urethral stricture, penile curvature after correction, length of urethral defect, length of reconstructed urethra, indwelling catheter size and duration. The study population was divided into a group with UD and a group without UD, and univariate and multivariate analyses were performed.

RESULTS

Among 159 patients with a mean follow-up of 31.87 ± 10.32 months, 14 (8.64%) patients developed UD after urethroplasty surgery. According to the univariate analysis, a narrower glans width (P = 0.018), a higher BMI (P = 0.019), the application of a modified onlay island flap (MOIF, P = 0.003), and urethral stricture (P = 0.010) were significantly associated with postoperative UD. Glans width (P = 0.023, OR = 0.444, 95% confidence interval [CI]: 0.220-0.895), BMI (P < 0.001, odds ratio [OR] = 1.808, 95% CI: 1.318-2.481), the application of MOIF (P = 0.007, OR = 10.670, 95% CI: 1.913-59.505) and urethral stricture (P = 0.015, OR = 10.010, 95% CI: 1.554-64.470) were independent factors for postoperative UD.

CONCLUSIONS

A narrower glans width, a higher BMI, the application of MOIF, and urethral stricture are significant factors contributing to the development of UD in patients with hypospadias following DUP.

Obesity promotes urinary tract infection by disrupting urothelial immune defenses

Obesity is a significant public health concern that is associated with numerous health risks. Infections are a major complication of obesity, but the mechanisms responsible for increased infection risk are poorly defined. Here, we use a diet induced obesity mouse model and investigate how obesity impacts urinary tract infection (UTI) susceptibility and bladder immune defenses. Our results show that high-fat diet fed female and male mice exhibit increased susceptibility to uropathogenic E. coli (UPEC) following experimental UTI. Transcriptomic analysis of bladder urothelial cells shows that obesity alters gene expression in a sex-specific manner, with distinct differentially expressed genes in male and female mice, but shared activation of focal adhesion and extracellular matrix signaling. Western blot and immunostaining confirm activation of focal adhesion kinase, a central component of the focal adhesion pathway, in the bladders of obese female and male mice. Mechanistically, experiments using primary human urothelial cells demonstrate that focal adhesion kinase overexpression promotes UPEC invasion. These findings demonstrate that obesity enhances UTI susceptibility by activating focal adhesion kinase and promoting bacterial invasion of the urothelium. Together, they explain how obesity promotes UTI vulnerability and identify modifiable targets for managing obesity-associated UTI.

Significance Statement

Obesity is associated with an increased risk of urinary tract infections (UTIs), but the underlying mechanisms promoting infection susceptibility remain poorly understood. Here, we show that diet-induced obesity drives sex-specific changes in bladder urothelial gene expression, including distinct immune responses in male and female mice. Despite these differences, both sexes exhibit activation of focal adhesion kinase (FAK). FAK overexpression promotes bacterial invasion into human bladder cells. These findings provide a mechanistic explanation for obesity-associated UTI susceptibility and suggest that targeting FAK signaling could offer a therapeutic strategy to prevent UTIs, with implications for personalized interventions in obesity.

Meta-analysis of the Risk Factors for Urinary Tract Infection in Children

CONTEXT

The incidence of urinary tract infection (UTI) varies with age, but there is limited evidence on the role of other risk factors.

OBJECTIVE

The aim of this meta-analysis was to investigate the risk factors for UTIs in children.

DATA SOURCES

PubMed from 1966 to May 2019.

STUDY SELECTION

All studies assessing at least 1 possible risk factor for occurrence or recurrence of UTI with a clear definition of symptomatic UTI in children were eligible. We excluded studies with UTIs related to hospital treatment or severe congenital renal abnormalities.

DATA EXTRACTION

After the quality assessment we extracted data on the given risk factor in children with and without UTI. The data were extracted separately for the occurrence and recurrence of UTIs.

RESULTS

We included 24 studies in the meta-analysis. Circumcision decreased the occurrence of UTIs with an odds ratio (OR) of 0.1 [95% confidence interval (CI): 0.06-0.17) and breast-feeding with an OR of 0.4 (CI: 0.19-0.86), both with low heterogeneity. Being overweight or obese increased the risk of UTI (OR: 2.23; CI: 1.37-3.63). Both poor fluid intake (OR: 6.39; CI: 3.07-13.39) and infrequent voiding (OR: 3.54; CI: 1.68-7.46) were associated with recurrent UTIs.

LIMITATIONS

The design, populations and definitions varied between the studies.

CONCLUSIONS

Being overweight or obese and having poor fluid intake are modifiable risk factors that increase the risk for UTIs in children. Breast-feeding and circumcision are associated with a decreased occurrence of UTIs.

Obesity and febrile urinary tract infection in young children

BACKGROUND

Obesity is a risk factor for infectious diseases. However, the relationship between obesity and febrile urinary tract infection (fUTI) is controversial. This study aimed to determine the relationship between obesity and fUTI in young children.

METHODS

We analyzed the medical records of children aged <2 years who were admitted to our hospital because of fever between April 2013 to March 2018. The children were categorized into three groups of non-obese, overweight, and obese according to the World Health Organization weight-for-length curves for children aged <2 years.

RESULTS

A total of 600 patients were enrolled in this study, of whom 118 were diagnosed with first fUTI. Patients in the fUTI group were younger than those in the control group (patients who were diagnosed with other febrile diseases) (5 ± 5.11 vs 11 ± 6.53 months; P < 0.001). There were no significant differences in the populations of overweight and obese children between the fUTI and control groups. In the fUTI group, the duration of fever, types of pathogen, recurrent rate, the grades of vesicoureteral reflux, and renal scarring were not associated with obesity. The white blood cell count and C-reactive protein levels were not significantly different among the three weight-for-length categories. The same results were obtained when the fUTI group was compared with an age-matched control group (n = 192, 4 ± 2.55 months old; P = 0.261).

CONCLUSIONS

Obesity is not a significant risk factor for fUTI in febrile hospitalized young children. Our study suggests that conducting urinalysis for febrile young children without obvious sources, irrespective of obesity, should be considered.

Demographic, clinical, and laboratory factors associated with renal parenchymal injury in Iranian children with acute pyelonephritis

Background

The association between renal parenchyma changes on dimercaptosuccinic acid (DMSA) scans and demographic, clinical, and laboratory markers was assessed in pediatric patients with acute pyelonephritis.

Methods

A retrospective study of 67 Iranian babies and children aged 1-month to 12-year with APN was conducted between 2012 and 2018. The presence of renal parenchymal involvement (RPI) during APN was determined using technetium-99m DMSA during the first 2 weeks of hospitalization. The association of DMSA results with demographic data, clinical features (hospitalization stay, fever temperature and duration), and laboratory parameters such as pathogen type, and hematological factors (ESR, CRP, BUN, Cr, Hb, and WBC) was evaluated.

Results

92.5% of children with an average age of 43.76 ± 5.2 months were girls. Twenty-four children (35.8%) did not have renal parenchymal injury (RPI), while 26 (38.8%) and 17 (25.4%) patients showed RPI in one and both kidneys, respectively. There was no significant association between RPI and mean ESR, CRP, BUN, and WBC. However, there were significant associations between RPI and higher mean levels of Cr, Hb, and BMI.

Conclusions

Low BMI and Hb levels and increased Cr levels might be indicative of the presence of RPI in children with APN.

Impact of early-life weight status on urinary tract infections in children: a nationwide population-based study in Korea

OBJECTIVES

We aimed to evaluate the association between early-life weight status and urinary tract infection (UTI) risk in children.

METHODS

A nationwide study was conducted using Korean National Health Screening (NHS) data and National Health Insurance Service data. A sample cohort was selected using data from the 2014 and 2015 NHS for infants and children (4-71 months) and followed up until the end of 2017. Participants were divided into 4 groups (underweight, normal weight, overweight, and obese) based on the weight-for-age (< 2 years) or body mass index (≥ 2 years). Hazard ratios (HRs) with 95% confidence intervals (CIs) for developing UTIs, cystitis, and acute pyelonephritis (APN) were calculated using a Cox proportional hazard model.

RESULTS

Of 1,653,106 enrolled children, 120,142 (7.3%) developed UTIs, cystitis, and APN during follow-up. The underweight, overweight, and obese groups had higher risks of UTIs than the reference group after adjusting for age, sex, birth weight, and preterm birth. Between 2 years and 6 years of age, boys with underweight had a high risk of UTI and APN, while girls with overweight and obesity revealed elevated risks of UTIs, cystitis, and APN. The HRs for APN in boys with underweight and in girls with obesity were 1.46 (95% CI, 1.03 to 2.07) and 1.41 (95% CI, 1.13 to 1.75), respectively, after adjusting for age, sex, birth weight, and preterm birth. The incidence of APN did not decrease with age in underweight and obese children aged 2-6 years.

CONCLUSIONS

Children with underweight, overweight, and obesity may be at high risk for UTIs.

Urinary Tract Infection in Children

BACKGROUND

Urinary Tract Infection (UTI) is a common infection in children. Prompt diagnosis and appropriate treatment are very important to reduce the morbidity associated with this condition.

OBJECTIVE

To provide an update on the evaluation, diagnosis, and treatment of urinary tract infection in children.

METHODS

A PubMed search was completed in clinical queries using the key terms "urinary tract infection", "pyelonephritis" OR "cystitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature and the pediatric age group. Patents were searched using the key terms "urinary tract infection" "pyelonephritis" OR "cystitis" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com.

RESULTS

Escherichia coli accounts for 80 to 90% of UTI in children. The symptoms and signs are nonspecific throughout infancy. Unexplained fever is the most common symptom of UTI during the first two years of life. After the second year of life, symptoms and signs of pyelonephritis include fever, chills, rigor, flank pain, and costovertebral angle tenderness. Lower tract symptoms and signs include suprapubic pain, dysuria, urinary frequency, urgency, cloudy urine, malodorous urine, and suprapubic tenderness. A urinalysis and urine culture should be performed when UTI is suspected. In the work-up of children with UTI, physicians must judiciously utilize imaging studies to minimize exposure of children to radiation. While waiting for the culture results, prompt antibiotic therapy is indicated for symptomatic UTI based on clinical findings and positive urinalysis to eradicate the infection and improve clinical outcome. The choice of antibiotics should take into consideration local data on antibiotic resistance patterns. Recent patents related to the management of UTI are discussed.

CONCLUSION

Currently, a second or third generation cephalosporin and amoxicillin-clavulanate are drugs of choice in the treatment of acute uncomplicated UTI. Parenteral antibiotic therapy is recommended for infants ≤ 2 months and any child who is toxic-looking, hemodynamically unstable, immunocompromised, unable to tolerate oral medication, or not responding to oral medication. A combination of intravenous ampicillin and intravenous/intramuscular gentamycin or a third-generation cephalosporin can be used in those situations. Routine antimicrobial prophylaxis is rarely justified, but continuous antimicrobial prophylaxis should be considered for children with frequent febrile UTI.

Obesity and risk of urinary tract infection in young children presenting with fever

Obesity may increase the risk of infection, but the association between obesity and febrile urinary tract infection (fUTI) is controversial. Although the prevalence of infant and childhood obesity has been increasing worldwide, the results of previous investigations on the association with urinary tract infection (UTI) are conflicting. The purpose of this study was to evaluate the relationship between overweight and obesity and UTI in febrile children.The study reviewed medical records of a consecutive series of 472 children <2 years of age presenting with fever ≥ 38°C were retrospectively evaluated and stratified by the presence or absence of a UTI. The proportions of underweight, healthy weight, overweight, and obese children in the 2 groups were compared following calculation of individual weight-for-length percentiles. The effect of obesity on UTI risk was evaluated, and odds ratios (ORs) were calculated.A total of 212 patients with and 260 controls without UTI were included. There were more overweight and obese children with (71/212, 33.5%) than without UTIs (45/260, 17.3%; P < .001). The OR of UTI in overweight relative to healthy-weight children was 1.92 [95% confidence interval (95% CI):1.15-3.21]. The OR of UTI in obese relative to healthy weight children was 2.46 (95% CI: 1.54-3.93).Compared with previous studies that made comparison between UTI and healthy children, this is the first study to demonstrate an association of obesity and fUTI in febrile children <2 years of age. In this series of pediatric patients, obesity was strongly associated with the presence of fUTI and obese children had a higher risk of developing an UTI than nonobese children.The incidence of UTI was higher in young, overweight, and obese children presenting with fever than in normal-weight, febrile children. Control of excess body weight should be considered as early as possible. Urinalysis should be considered for obese children <2 years of age who present with fever, especially those with mild respiratory or gastrointestinal symptoms.

Dexmedetomidine-Associated Hyperthermia: A Retrospective Cohort Study of Intensive Care Unit Admissions between 2009 and 2016

Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature ≥39.5°C, including patient characteristics, temporality and potential risk factors. We conducted a retrospective cohort study of all intensive care unit (ICU) admissions between 1 July 2009 and 31 May 2016 in a tertiary ICU in Australia. Temperature data was available for 9,782 ICU admissions. Dexmedetomidine was given intravenously to 611 (6.3%) patients at a dose of 0 to 1.5 g/kg/hour. Temperatures ≥39.5°C were recorded in 341 (3.5%) patients. Overall hospital mortality was 10.8% for all admissions and 29.3% for patients with temperatures ≥39.5°C. Dexmedetomidine exposure was more frequent in patients with temperature recordings ≥39.5°C compared to those with temperatures <39.5°C, 11.94% versus 2.94% (odds ratio [OR] 4.49; 95% confidence intervals [CI] 3.37, 5.92; P <0.001). The association was stronger for patients post-open heart surgery (OHS) with temperatures ≥39.5°C (OR 12.9; 95% CI 5.01, 31.62; P <0.001). Multivariate analysis showed an independent association between dexmedetomidine and a temperature ≥39.5°C in two particular patient groups: OHS (OR 2.72; 95% CI 1.1, 6.9; P <0.001), and obesity (OR 3.44; 95% CI 1.5, 7.9; P <0.001). Dexmedetomidine exposure is associated with an increased risk of hyperthermia. Possible risk factors are open heart surgery and obesity.

The impact of obesity on pediatric inpatients with urinary tract infections in the United States

INTRODUCTION

Urinary tract infections (UTI) are common infectious disorders, and obesity is an increasing public health problem worldwide. Several studies have suggested that childhood obesity may be associated with the development of UTI. However, the potential effects of obesity on the clinical outcomes of UTI in children remain unknown.

MATERIALS AND METHODS

Hospital discharge records for patients aged 18 years or younger with a diagnosis of UTI were extracted from the 2012 Kids' Inpatient Database. We used the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and classified each patient as obese or not. We compared the total hospitalization costs, total length of hospital stay in days, and risks of hypertension, acute kidney injury, and septicemia between obese and non-obese patients, using propensity score matching and stabilized inverse probability weighting methods.

RESULTS

Of 51,918 patients with UTI, 1488 were obese and 50,430 were non-obese. A multivariable logistic regression model calculated propensity scores using baseline characteristics as dependent variables. One-to-one propensity matching created 1488 pairs. In the propensity-matched analyses, a significant difference was observed between the obese and the non-obese for risks of hypertension (8.1% vs. 1.8%; risk ratio 4.44; 95% CI 2.95-6.71). The total mean hospitalization cost in the obese group was 1.29 times higher than that in the non-obese group (95% CI 1.13-1.47). The total mean length of hospital stay in the obese group was 1.29 times longer than that in the non-obese group (95% CI 1.16-1.44). Stabilized inverse probability weighting analyses showed similar results to the propensity matched analyses (Table), except for a significant result for the risk ratio for acute kidney injury (risk ratio 1.64; 95% CI 1.18-2.26.

CONCLUSIONS

These findings indicate that obesity may be an important risk factor for hypertension and acute kidney injury among hospitalized children with UTI. Obesity may also be an economically complicating factor for their hospitalizations, which indicates the importance of the prevention for obesity.

Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16-year tertiary single-institution experience

BACKGROUND

Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol.

PROCEDURE

We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection.

RESULTS

Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively).

CONCLUSIONS

Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection.

The impact of obesity on febrile urinary tract infection and renal scarring in children with vesicoureteral reflux

INTRODUCTION

It has become clear that obesity is associated with a variety of infectious diseases, including urinary tract infection (UTI) and renal scarring.

OBJECTIVE

The aim of this study was to evaluate the association between obesity and the degree of febrile UTI (fUTI) and renal scarring in children with vesicoureteral reflux (VUR), and to stratify the results into obesity subcategories.

STUDY DESIGN

A total of 186 patients were diagnosed with VUR between January 2002 and December 2008. This study retrospectively reviewed the medical records of 72 children with primary VUR who had recurrent fUTI (more than twice). Overweight or obese status of the patients aged <2 years was defined using weight-for-length (WFL) measurements. For 2-5 year old children, body mass index (BMI) percentile-for-age was used. They were divided into three groups as follows; standard (<85%), overweight (85-95%), and obese (≥95%). The following clinical variables were compared: age at diagnosis of primary VUR (months), sex, VUR grade, hydronephrosis grade, presence of renal scarring, surgical treatment, and degree of inflammation during fUTI.

RESULTS

In the overweight and obese groups, VUR was diagnosed at a young age (P = 0.05), the degree of renal scarring was more severe (P = 0.006), and serum white blood cell count, C-reactive protein, and erythrocyte sedimentation rate (ESR) levels were significantly higher (P < 0.001, P < 0.001, and P < 0.001, respectively). Abnormal focal dimercaptosuccinic acid (DMSA) defects were present in 25 of the 72 children (35%). Cortical defects occurred more frequently in children with obesity, and they were associated with a higher grade of reflux and serum ESR levels (P = 0.007, P = 0.042, and P = 0.021, respectively). Among these risk factors, high-grade VUR (OR = 9.93, 95% CI = 1.13-86.71), and being overweight and obese (OR = 5.26, 95% CI = 1.75-15.82) were associated with increased renal scarring. However, ESR was not associated with renal scarring (OR = 1.01, 95% CI = 0.95-1.07).

DISCUSSION

The relationships between obesity and UTI are controversial. Some studies have shown positive results; however, other studies have shown opposite results. The main limitations of this study were the retrospective data collection via electronic medical records, and the small number of subjects.

CONCLUSIONS

This study showed that obesity in patients with VUR has an effect on fUTI and renal scar formation. If the patients with VUR have obesity, close follow-up should be performed, and VUR patients should be started on a weight-loss program, which could reduce the number of patients with chronic kidney disease in the future.

Obesity Impacts Fever and Sickness Behavior During Acute Systemic Inflammation

Obesity is reaching dramatic proportions in humans and is associated with a higher risk for cardiovascular disease, diabetes, and cognitive alterations, and a higher mortality during infection and inflammation. The focus of the present review is on the influence of obesity on the presentation of fever, sickness behavior, and inflammatory responses during acute systemic inflammation.

Association of BMI and pediatric urologic postoperative events: Results from pediatric NSQIP

BACKGROUND

Elevated body mass index (BMI) is a well-known risk factor for perioperative complications in adults, but has not been investigated in children undergoing urologic procedures. Given the low rate of complications associated with urologic surgery, a large sample is required for their characterization, but BMI is frequently not available in administrative databases. Here we report results from the first nationally based, prospectively assembled cohort analyzed with respect to the association of BMI with 30-day postoperative events for pediatric urologic procedures.

OBJECTIVE

To determine the association of elevated BMI with overall 30-day postoperative events and wound complications in a large national sample of children undergoing urologic procedures.

STUDY DESIGN

We queried the 2012 Pediatric National Surgical Quality Improvement Program database (NSQIP), defining obesity as a BMI above the 95th percentile and overweight above the 85th percentile, per CDC definitions. We used BMI <85th percentile as a referent group. Complications were collected within 30 days of the procedure. Comorbidity was classified on a linear scale using a validated pediatric-specific comorbidity score, and procedures were classified as genital, abdominal without bowel involvement, or abdominal with bowel involvement. Univariate and multivariate logistic models were used to test significance of associations.

RESULTS

2871 patients aged 2-18 years were analyzed. Of these, 420 (14.6%) were overweight and 440 (15.3%) were obese. A summary of 30-day events and complications is shown in the structured abstract table. On multivariate analysis adjusting for age, gender, class of procedure, and comorbidity, BMI remained a significant risk factor for 30-day events when comparing BMI ≥85th percentile to BMI <85th percentile (OR 1.36, 95% CI 1.03-1.8, p = 0.035). An exploratory subgroup analysis examining the rate of wound complications demonstrated an odds ratio of 2.36 (95% CI 1.28-4.35, p = 0.006) for BMI >85th percentile on multivariate analysis.

DISCUSSION

Overweight/obese status increased the odds of overall complications by 36%, and of wound complications by 140%. In adults there is a known profound effect of body composition on wound complications, but in children this association is less clear, and has not been studied in the pediatric urologic literature on a large scale. The mechanisms linking BMI to pediatric postoperative complications are unclear, but cytokine mechanisms or changes in the response to inflammation have been postulated. Limitations of this study include restriction to those urologic procedures included in ACS-NSQIPP and sorted into broad general categories. We did not control for secondary procedures. BMI/BMI percentile may not be appropriate measures of body composition in patients with atypical body habitus or proportions (e.g. myelomeningocele).

CONCLUSION

BMI in the pediatric NSQIP urologic population was found to be associated with overall complication after adjustment for case type and preoperative comorbidity in a large national sample assembled for assessment of perioperative outcomes. An exploratory analysis uncovered more than two-fold increase in odds of wound complication in obese/overweight patients compared with a normal weight referent population. These results may be useful in preoperative counseling patients regarding perioperative risk.

Association between body mass index and urinary tract infection in adult patients

Background:

Overweight and obesity have become a global public health over the last decades. Obesity has been suggested to be a risk factor for some infections, but studies often showed controversial findings. Few studies examined the relationship between body mass index (BMI) and urinary tract infection (UTI), showing inconsistent results.

Objectives:

The purpose of this study was to determine the relationship between BMI and UTI in adult patients.

Patients and Methods:

Adult patients (≥ 18 years old) who were referred to clinics or admitted in hospital with diagnosis of UTI were considered for participation in the study. Control group were selected from healthy adult normal population whom underwent medical check-ups at the same hospital and without history of UTI. Data about age, gender, history of diabetes mellitus and BMI were registered for individuals who met inclusion criteria.

Results:

A total of 116 patients with UTI and 156 people as the control group were included in the study. Two groups were matched for age, gender and history of diabetes mellitus. Mean BMI ± SD of patients was 25.2 ± 4.0 kg/m² and the controls was 25.1 ± 3.6 kg/m². There was no significant correlation between BMI and UTI (P = 0.757). Mean BMI ± SD of patients with upper UTI was 25.6 ± 4.1 kg/m² and for lower UTI was 24.9 ± 4.0 kg/m². There was no significant difference between BMI of controls and patients with any type of UTI (P = 0.573).

Conclusions:

Our findings did not found an association between BMI and UTI and does not support obesity as a risk factor for UTI in adult patients.