P17 Baseline characteristics, disease progression rates and risk factors among female patients with uncomplicated urinary tract infection in England

BACKGROUND AND OBJECTIVES: Uncomplicated urinary tract infection (uUTI) is a common, usually community-acquired bacterial infection. Little is known about risk factors for disease progression (defined here as hospitalization for Escherichia coli sepsis, bacteraemia or acute pyelonephritis) among patients with uUTI. We report the baseline demographic and clinical characteristics among female uUTI patients with/without disease progression in England. METHODS: This retrospective cohort study utilized anonymized patient data from 1 January 2018 to 31 December 2019 from the Clinical Practice Research Datalink (CPRD) database linked to English Hospital Episode Statistics data. Eligible patients were female, aged ≥12 years, had received an index diagnosis for a community-acquired uUTI, had ≥12 months’ CPRD data history, and had received ≥1 oral antibiotic within ±5 days of diagnosis. Patients were excluded if they had complicated UTI or complicating comorbidities, were hospitalized/visited an accident and emergency department 28 days prior to index or had received IV antibiotics as initial therapy. uUTI episodes were defined as the 28 days post-index (Figure 1). Descriptive patient (demographic and clinical characteristics), region and practice-level characteristics in the 12 month baseline period are presented for patients with/without disease progression. [Figure: see text] RESULTS: Among 116793 female patients with a uUTI, 207 were hospitalized for E. coli sepsis, bacteraemia or acute pyelonephritis within 28 days of index (0.2%). The mean age (SD) for patients with/without progression was 67.3 (20.2) and 52.9 (21.1), respectively; 81% and 34% of patients with/without progression were ≥50 years old. Imbalances were observed for comorbid burden, baseline medications, initial presentation (i.e. home visit requirement) and prior antimicrobial treatment (Table 1). Few regional or practice-level differences were apparent (Table 1). [Table: see text] CONCLUSIONS: Hospitalization following uUTI is rare in this study, however, at a population level, this still affects a large number of female patients. Coding limitations meant potentially linked admissions (e.g. falls and confusion) could not be identified. Hospitalizations appear to be driven by patient factors rather than regional differences or practice patterns. The role of these putative risk factors for disease progression will be explored further via multivariable logistic regression analysis.