title: A prevalence study of urinary tract infections in acute relapse of schizophrenia.
abstract: OBJECTIVE
  Schizophrenia is associated with immune abnormalities and increased mortality from infectious diseases. The aim of this study was to examine whether acute relapse of schizophrenia was associated with urinary tract infection (UTI), in comparison with controls, after controlling for potential confounding factors.
  
  
  METHODS
  In a prevalence study conducted from January 2010 to April 2012 at Georgia Health Sciences University Medical Center, Augusta, we recruited 136 adult subjects (mean age = 42.8 years): 57 inpatients with an acute relapse of DSM-IV schizophrenia, 40 stable outpatients with DSM-IV schizophrenia, and 39 healthy controls from the community. Urinary tract infection was defined as having positive leukocyte esterase and/or positive nitrites on urinalysis and having ≥ 5 leukocytes per high-powered field (implies 5-10 or more) on urine microscopy. Determination of UTI status was made for each subject, and analyses were performed to examine the association between UTI and acute relapse of schizophrenia.
  
  
  RESULTS
  35% of acutely relapsed subjects, versus 5% of stable outpatients and 3% of controls, had a UTI (P < .001). Only 40% of subjects in the acute relapse group classified as having a UTI were treated with antibiotics during hospitalization. After analyses were controlled for gender and smoking status, subjects in the acute relapse group were almost 29 times more likely to have a UTI than controls (odds ratio = 28.97; 95% CI, 3.44-243.85; P = .002). There was no statistically significant association with UTI among the stable outpatients versus controls.
  
  
  CONCLUSIONS
  Our finding of an association between an increased prevalence of UTI and acute psychotic relapse warrants replication in other samples. The mechanism of this association remains unclear. The results also highlight the potential importance of monitoring for comorbid UTI in acutely relapsed patients with schizophrenia.
authors.affiliation: Department of Psychiatry and Health Behavior, Georgia Health Sciences University, 997 Saint Sebastian Way, Augusta, GA 30912, USA. brmiller@georgiahealth.edu
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Miller
authors.forename: Krystle L
authors.initials: KL
authors.lastname: Graham
authors.forename: Chelsea M
authors.initials: CM
authors.lastname: Bodenheimer
authors.forename: Nick H
authors.initials: NH
authors.lastname: Culpepper
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Waller
authors.forename: Peter F
authors.initials: PF
authors.lastname: Buckley
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010045:Outpatients / Q000706:statistics & numerical data*; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D013223:Statistics as Topic; D016482:Urinalysis / Q000379:methods; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology / Q000652:urine
chemical_list: D000900:Anti-Bacterial Agents