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CHICAGO, April 30 -- Sex and alcohol often figure prominently in a young woman's first urinary tract infection (UTI), according to a study of college coeds.

Sexual activity had the strongest influence on a first UTI, but alcohol use correlated with the two strongest risk factors, both of which involved sexual activity, Charles Vincent, M.D., of the University of Florida in Gainesville, reported at the American Urological Association meeting.

More surprisingly, frequent consumption of caffeine also emerged as a risk factor for UTI.

"Studies focused on UTI have previously demonstrated that sexual intercourse increases risk for UTI," said Dr. Vincent. "This risk factor is corroborated by this cohort.

"Few studies have suggested a relationship to coffee or tea consumption and alcohol consumption. Though causative relationships are not evident, these behaviors may suggest lifestyles that predispose risk factors of UTI development," he added.

Although UTIs affect women of all ages, most previous studies have focused on older groups with histories of multiple episodes. Dr. Vincent and colleagues sought to identify and examine risk factors for young women seeking treatment for their very first UTI.

Through the University of Florida Student Health Care Service, investigators recruited 180 women with a first UTI, along with 80 without UTI who served as the control group.

A single study nurse collected information about demographics, symptoms, lifestyle habits, and dietary intake. Urinalysis, urine cultures, and vaginal cultures were performed for all study participants.

The mean age of the study and control groups was about 21, and 60% to 70% of each group was Caucasian. The women in both groups had completed about 2.5 years of college, and 97% of each group were single.

The symptoms that most often led women in the UTI group to the student health service were urgency and frequency of urination. On average, they sought care two or three days after symptom onset.

Escherichia coli was the organism most often associated with UTI, accounting for about half of all infections. Ureaplasma urealyticum/parvum was the second most common isolate, accounting for about 15% of UTIs.

Analysis of potential factors associated with UTI identified sexual activity within the past two weeks and number of sex partners in the past two weeks as the strongest predictors (P<0.001). Vaginal intercourse in the past two weeks also had a significant association with UTI (P=0.002).

Urination practices (such as direction of wiping) and use of tampons or sanitary pads did not play a significant role in UTI risk.

Alcohol consumption by itself did not significantly contribute to UTI risk. However, frequency of alcohol consumption was significantly associated with sexual activity and with vaginal intercourse within the past two weeks.

The analysis also revealed a strong trend toward association between alcohol consumption and number of sexual partners within the past two weeks.

"The association between alcohol consumption and sexual activity may reflect a phenomenon involving impaired judgment, leading to increased sexual activity," said Dr. Vincent.

In multivariate analysis, increased consumption of caffeinated drinks and receiving oral sex also emerged as significant predictors of UTI (P<0.04 and P<0.03, respectively).

"What we would like to get out about this study is that urinary tract infection is common, affecting millions of women," said Dr. Vincent. "In some cases, the infection recurs, and in 5% of women, the infection occurs repeatedly.

"Understanding the risk factors associated with UTI, modifying lifestyle accordingly, and knowing when to present to a doctor are the important aspects of the study."

Dr. Vincent reported no competing interests.

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