EPIDEMIOLOGY OF UNCOMPLICATED OUTPATIENT URINARY TRACT INFECTIONS IN THE RUSSIAN FEDERATION
Authors: Rafalsky V. V. , Moiseeva E. M. 
Published: July 2018

Introduction.Urinary tract infections (UTIs) are one of the most common bacterial infections of practical interest to specialists in different areas. The most common form of UTI is acute uncomplicated cystitis (AUC). To date, there is a limited number of studies devoted to the study of this problem in the Russian Federation.

Purpose of research.The aim of this study was to assess the prevalence and clinical features of communitybased UTI in Russia.

Materials and methods.The study was conducted in two stages, the first stage was completed in 2005- 2006, the second stage – in 2017, the method of questionnaire was used. During the first stage, young women were surveyed in organized groups (Universities and Colleges) using a paper traditional questionnaire in 20 cities of the Russian Federation, the Republic of Belarus and Kazakhstan. The second stage of the research was carried out using the technology of online surveys. Information about the online questionnaire was shared at specialized events in which mainly young people of 18-25 years participated – lectures at Universities, youth events, social networks, etc. During the second stage of the study, 20 cities of the Russian Federation were covered.

Results.At the first stage of the study, 660 women were interviewed, the average age was 20.9 ± 1.6 (median - 18.0) years. At least one episode of dysuria was reported by 19.0% ± 1.5% of the respondents, with 22.9% of the respondents having recurrent cystitis. In the second stage of the study, 525 respondents were interviewed, the average age was 21.1 ± 1.8 years. The occurrence of at least one episode of dysuria during the life о21.1% ± 1.7 of the respondents, while 28.5% of ± 2.0 of the respondents reported the development of 3 or more episodes of the dysuria over the last 12 months.

The median duration of cystitis symptoms was 2 days in both the first and second stages of the study. Most often, symptoms of dysuria persisted 1-3 days (64.1%), 4-5 days (23.0%) or 5-7 days (9.5%). The most correlated with the development of cystitis were family history (OR - 2.26-2.42), sexual activity and use of spermicides (OR – 1.69 and 2.43). From 40% to 50.9% of respondents in the case of dysuria do not seek medical care. When reached a medical care, most often consulted a doctor urologist (15.8% - 22.3%), gynecologist (16.7% - 17.7%), rarely a therapist (8.8 – 11.4) or other specialties (1.3% - 14.8%). No pharmacological treatments were used and 20.1% - 23.1% of the respondents, herbal medicine – 24.0% - 23.9%. Antibiotics, spasmolytic drugs and NSAIDs were the most commonly used. Over the past 12 years, there have been significant changes in the structure of antibiotics used in cystitis – the frequency of use of ampicillin, amoxicillin, co-trimoxazole, gentamicin has clearly decreased. On the contrary, increased frequency of use of phosphomycin, norfloxacin, levofloxacin.

Conclusions.According to the survey of young women, 19.1%-21.1% of respondents report the occurrence of symptoms of AUC. 22.9% - 28.5% of women report the development of 3 or more episodes of dysuria during the year. Usually clinical symptoms persist for 2 days (median), the duration of dysuria in the range of 1-3 days reported 64.1% - 70.9% of patients. The risk of AUC correlated with the activity of sexual life, family history of UTI, spermicides using – OR – 1.69, 2.42 and 2.43, respectively. 40.3-50.9% patients with AUC did not seek medical care, the main method of treatment of cystitis in an outpatient setting is the use of antibiotics.

Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.