Symptoms and Risk Factors Associated with First Urinary Tract Infection in College Age Women: A Prospective Cohort Study

Purpose: We identified epidemiological risk factors for the initial urinary tract infection in females of college age compared to age matched controls. Materials and Methods: We performed a prospective cohort study from July 2001 to January 2006 at the student health care facility at our institution. A total of 180 women experiencing a first urinary tract infection were compared to 80 asymptomatic women with no urinary tract infection history who served as controls. Urinalysis and urine culture were done at study enrollment. Questionnaires were used to obtain information on clinical symptoms and behaviors, including sexual and dietary practices, and alcohol consumption. Logistic regression was performed to identify potential risk factors in women who presented with an initial urinary tract infection compared with controls. Principal component analysis was then done to identify key sexual activity variables for multiple regression models. Results: Urinary frequency and urgency were the most common urinary tract infection symptoms. Recent sexual activity was a significant risk factor for urinary tract infection with vaginal intercourse (p = 0.002) and the number of sexual partners in the last 2 weeks (p <0.001) as the 2 primary variables. Alcohol consumption was associated with 2 of the 3 main principal components of sexual activity. Caffeinated beverage consumption also increased the risk of urinary tract infection (p <0.04). Escherichia coli was the predominant pathogen isolated, followed by urease positive microbes. Conclusions: Recent sexual activity, the frequency of that activity and the number of sexual partners pose an increased risk of urinary tract infection. Alcohol consumption frequency and amount correlated with these behaviors.