title: Association between use of spermicide-coated condoms and Escherichia coli urinary tract infection in young women.
abstract: Diaphragm/spermicide use increases the risk of urinary tract infection (UTI). To determine whether spermicide-coated condoms are also associated with an increased risk of UTI, the authors conducted a case-control study at a large health maintenance organization in Seattle, Washington. Cases were sexually active young women with acute UTI caused by Escherichia coli, identified from computerized laboratory files during 1990-1993. Age-matched controls were randomly selected from the enrollment files of the plan. Of 1,904 eligible women, 604 cases and 629 controls (65%) were interviewed. During the previous year, 40% of the cases and 31% of the controls had been exposed to any type of condom. The unadjusted odds ratio for UTI increased with frequency of condom exposure from 0.91 (95% confidence interval (CI) 0.65-1.28) for weekly or less during the previous month to 2.11 (95% CI 1.37-3.26) for more than once weekly. Exposure to spermicide-coated condoms conferred a higher risk of UTI, with odds ratios ranging from 1.09 (95% CI 0.58-2.05) for use weekly or less to 3.05 (95% CI 1.47-6.35) for use more than once weekly. In multivariate analyses, intercourse frequency (odds ratio (OR) = 1.14 per weekly episode), history of UTI (OR = 2.64), and frequency of spermicide-coated condom exposure (OR = 3.34 for more than once weekly and 5.65 for use more than twice weekly) were independent predictors of UTI. Spermicide-coated condoms were responsible for 42% of the UTIs among women who were exposed to these products.
authors.affiliation: Northwest Health Services Research and Development Field Program, Veterans Affairs Medical Center, Seattle, WA 98108, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Fihn
authors.forename: E J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: E H
authors.initials: EH
authors.lastname: Normand
authors.forename: C L
authors.initials: CL
authors.lastname: Chen
authors.forename: J R
authors.initials: JR
authors.lastname: Grafton
authors.forename: M
authors.initials: M
authors.lastname: Hunt
authors.forename: P
authors.initials: P
authors.lastname: Yarbro
authors.forename: D
authors.initials: D
authors.lastname: Scholes
authors.forename: A
authors.initials: A
authors.lastname: Stergachis
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D017280:Condoms / Q000706:statistics & numerical data; D015986:Confounding Factors, Epidemiologic; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D012307:Risk Factors; D013089:Spermatocidal Agents; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*; D014861:Washington / Q000453:epidemiology
chemical_list: D013089:Spermatocidal Agents