OBJECTIVES: There are few contemporary data on urinary tract infection (UTI) rates in the United States (US). Historically, complicated UTIs (cUTIs) were considered to be encountered in inpatient or emergency department (ED) settings. This study aimed to describe the prevalence and burden of cUTI and uncomplicated UTI (uUTI) in the US ambulatory setting using nationally representative data of office-based physician practices.

METHODS: Healthcare encounters with a UTI diagnosis among individuals aged ≥15 years were identified using the 2016, 2018, and 2019 National Ambulatory Medical Care Surveys overall and stratified by uUTI and cUTI, defined by regulatory and professional society guidelines. The multiplicity estimator method was used to extrapolate patient-level counts and US Census Bureau data were utilized to ascertain annualized prevalence.

RESULTS: Across the 3 years, 9,799,054 annualized UTI encounters were identified, with an annualized prevalence of 1,511 (95% confidence interval [CI]:1,234–1,787)/100,000-persons. Overall, cUTIs accounted for 42.2% of UTI encounters. Annualized prevalence of uUTIs and cUTIs was 851 (95%CI:685–1,017) and 659 (95%CI:495–824)/100,000-persons, respectively. UTI encounters in males were defined as cUTIs, while cUTIs in females were predominantly secondary to urologic abnormalities (92.5%). Among females, the annualized prevalence of uUTIs and cUTIs was 1,473 (95%CI:1,185–1,761) and 330 (95%CI:231–428)/100,000-persons, respectively. Annualized cUTI prevalence in males was 966 (95%CI:637–1,296)/100,000-persons. Across all 3 years, UTI was ranked as the most common infection-related diagnosis and the 48^th (both sexes) and 36^th (females-only) most common diagnosis overall.

CONCLUSIONS: This study utilizing a nationally representative data source highlights UTI as a highly prevalent diagnosis in US office-based physician practices. Additionally, cUTI accounts for a significant portion of outpatient UTI encounters, primarily in men. Additional investigation is needed to better understand the burden of UTIs and associated healthcare utilization in inpatient, ED, and hospital-based ambulatory settings.