Seasonality of urinary tract infections in the United Kingdom in different age groups: Longitudinal analysis of The Health Improvement Network (THIN)

A. Rosello*, K. B. Pouwels, M. Domenech De Cellès, E. Van Kleef, A. C. Hayward, Susan Hopkins, Julie Robotham, Timo Smieszek, L. Opatowski, S. R. Deeny

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Evidence regarding the seasonality of urinary tract infection (UTI) consultations in primary care is conflicting and methodologically poor. To our knowledge, this is the first study to determine whether this seasonality exists in the UK, identify the peak months and describe seasonality by age. The monthly number of UTI consultations (N = 992 803) and nitrofurantoin and trimethoprim prescriptions (N = 1 719 416) during 2008-2015 was extracted from The Health Improvement Network (THIN), a large nationally representative UK dataset of electronic patient records. Negative binomial regression models were fitted to these data to investigate seasonal fluctuations by age group (14-17, 18-24, 25-45, 46-69, 70-84, 85+) and by sex, accounting for a change in the rate of UTI over the study period. A September to November peak in UTI consultation incidence was observed for ages 14-69. This seasonality progressively faded in older age groups and no seasonality was found in individuals aged 85+, in whom UTIs were most common. UTIs were rare in males but followed a similar seasonal pattern than in females. We show strong evidence of an autumnal seasonality for UTIs in individuals under 70 years of age and a lack of seasonality in the very old. These findings should provide helpful information when interpreting surveillance reports and the results of interventions against UTI.

Original languageEnglish
Pages (from-to)37-45
Number of pages9
JournalEpidemiology and Infection
Volume146
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Bibliographical note

Funding Information:
This work was supported by a Public Health England (PHE)-funded PhD studentship to A. Rosello. S. Hopkins was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford in partnership with PHE (grant number HPRU-2012-10041) and the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London in partnership with PHE (grant number HPRU-2012-10047). The remaining authors had no funding to declare.

Publisher Copyright:
Copyright © 2017 Cambridge University Press.

Keywords

  • The Health Improvement Network
  • Urinary tract infections (UTIs)
  • seasonality

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