Fatores de risco para infecção do trato urinário: revisão de escopo

Abstract

Urinary tract infections (UTIs) are common infections worldwide and rank among the leading causes of hospitalization due to pathogens, posing a significant threat to public health. Objective: To map the knowledge produced regarding risk factors for UTIs in adult and elderly populations across different types of healthcare services and in the community. Method: This review was conducted according to the Joanna Briggs Institute guidelines for scoping reviews. The research question guiding the study was: "What are the risk factors for urinary tract infections identified in adult and elderly populations in different healthcare services and in the community?" Inclusion criteria encompassed studies published within the last five years, involving adult patients, and written in English, Portuguese, or Spanish. The search was conducted in April 2023 in the following databases: Scopus, PubMed, Cochrane Library, Virtual Health Library (BVS), SciELO, and Web of Science. The keywords used were "risk factor," "urinary tract infection," "adults," "pyelonephritis," and "cystitis." The final sample consisted of 37 studies. Results: The included studies addressed different groups and contexts and were categorized into eight main themes: (1) Risk factors for UTIs in patients with diabetes mellitus; (2) in patients undergoing kidney transplantation; (3) in infections caused by multidrug-resistant bacteria; (4) in recurrent UTIs in women; (5) in patients undergoing surgical procedures and others; (6) in patients with neurological impairment; (7) in patients with long-term urinary catheterization; and (8) risk factors identified in studies addressing diverse topics. Various risk factors were identified depending on the population studied. A tendency was observed to explore risk factors within groups already known to be susceptible to developing UTIs, such as women and patients with diabetes mellitus, as well as in specific situations like infections caused by multidrug-resistant microorganisms, post-kidney transplantation, surgical procedures, and urinary catheterization. Conclusion: Given the complexity and magnitude of UTIs as a global health issue, it is crucial to develop further studies that consolidate existing knowledge and explore the existence of new risk factors across different populations and contexts, especially concerning community-acquired UTIs. It is also essential to identify effective measures for the prevention and control of UTIs by nursing and healthcare professionals.