Trends and disparities in urinary tract infections-related mortality in the United States from 1999 to 2023: Insights from CDC WONDER

Urinary tract infections (UTIs) rank among the most common bacterial infections globally, impacting around 404 million individuals each year. This research investigates trends in mortality associated with UTIs in adult patients across the United States from 1999 to 2023. We retrospectively examined death statistics from the CDC WONDER database, examining mortality trends where UTI was the primary or contributing cause. Age-adjusted mortality rates (AAMR) per 1,00,000 were computed and categorized by sex, race/ethnicity, urbanization, state, and census region. Trends were evaluated using joinpoint regression to determine annual percentage change (APC) with 95% confidence intervals. From 1999 to 2023, there were a total of 10,83,913 UTI-related deaths among individuals aged 25 and older. The overall AAMR decreased from 1999 to 2018 (APC: -0.80; 95% CI: -1.13 to -0.46), followed by a significant increase up to 2023 (APC: 3.95; 95% CI: 1.60-6.36). Females consistently displayed higher AAMRs compared to males. Non-Hispanic (NH) American Indian/Alaskan Native individuals experienced the highest (AAMR) among racial groups. In terms of geography, nonmetropolitan areas exhibited higher rates than metropolitan regions, while the South reported the highest AAMR when considering census regions. Tennessee had the highest AAMR (30.48) between 1999 and 2020. Mortality related to UTIs has been on the rise since 2018, with the most notable rates found among females, NH American Indian/Alaskan Native, nonmetropolitan residents, and those in the Southern region. These disparities emphasize the necessity for ongoing initiatives and targeted interventions aimed at these high-risk groups.