High prevalence of nosocomial infections in rehabilitation units accounted for by urinary tract infections in patients with spinal cord injury

Choe

Antimicrob Agents Chemother

et al. 2013

i This study aimed to (i) investigate the antimicrobial susceptibilities of bacteria that cause urinary tract infections (UTIs) in outpatient and inpatient settings and (ii) evaluate the risk factors for emerging antimicrobial drug resistance in UTIs in South Korea. In total, 3,023 samples without duplication were collected from females between 25 and 65 years of age who had been diagnosed with a urinary tract infection. Multicenter patient data were collected using a Web-based electronic system and then evaluated. The isolation rates of Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecium in the outpatient setting were 78.1, 4.7, and 1.3%, respectively; in the inpatient setting, the isolation rates of these microorganisms were 37.8, 9.9, and 14.8%, respectively. The susceptibilities of E. coli to amikacin, amoxicillin-clavulanic acid, cefotaxime, cefoxitin, ciprofloxacin, piperacillin-tazobactam, and imipenem in the outpatient setting were 99.4, 79.8, 89.4, 92.8, 69.8, 96.9, and 100.0%, respectively; in the inpatient setting, the susceptibilities to these antibiotics were 97.8, 73.9, 73.7, 82.1, 53.6, 93.2, and 100.0%, respectively. The most unique and common risk factor for emerging antimicrobial-resistant E. coli, K. pneumoniae, and E. faecium was previous exposure to antimicrobials. On the basis of these data, the use of fluoroquinolones should be reserved until culture data are available for the treatment of UTIs in South Korea. The present study will serve as a useful reference for Far Eastern Asia.

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility Pattern and Epidemiology of Female Urinary Tract Infections in South Korea, 2010-2011

Choe

Antimicrob Agents Chemother

et al. 2013

“…Studies attempting to assess the prevalence of UTIs across SCI patients found infection rates ranging from 10 to 68% post-SCI. 5,20,22,24,30,32,37,40,44 Four studies identified Infections in the spinal cord-injured population LY Garcia-Arguello et al UTI as the most common secondary condition affecting patients with SCI. 5,24,37,44 A study restricted to patients with SCI and fever found that UTI was commonly associated with coinfections such as infected decubitus ulcers, and osteomyelitis, but less common as a single source of infection.…”

Section: Urinary Tract Infectionsmentioning

confidence: 99%

Infections in the spinal cord-injured population: a systematic review

et al. 2016

Study Design: Spinal cord injury (SCI) patients are an increasing population due to recent military conflicts. SCI patients are at an increased risk of infection, but the epidemiology management and prevention strategies for these infections are unclear. Objective: To review the incidence, microbiology and management of pneumonia, skin and soft tissue infections (SSTI), urinary tract infections (UTI) and bloodstream infections in the SCI population via literature review. Methods: With the assistance of an experienced medical librarian, we developed a search strategy for the Ovid MEDLINE database and then adapted it for the Ovid Embase, Scopus and Web of Science databases. The databases were searched from their inception to April 2014 with no restrictions on language or time period. Data were extracted using a standardized form. All studies were reviewed by two independent investigators. Results: Forty-one studies reporting on the described infections were identified. UTIs were the most commonly identified infections, but studies failed to identify consistently effective preventive strategies. SSTIs were also common, and the best preventive strategies focused on decubitus ulcer prevention and skin decolonization protocols. Pneumonia management and course were not significantly different from the general population. Bloodstream infections were associated with delays in recognition, and were most often secondary to UTI, pneumonia or SSTI. Conclusion: There is a paucity of literature on consistently effective infection prevention strategies in SCI patients. Identification and implementation of evidence-based interventions that optimize prevention and management of infections in this patient population are needed. Spinal Cord (2017) 55, 526-534; doi:10.1038/sc.2016.173; published online 6 December 2016 INTRODUCTIONSpinal cord injury (SCI) is a medically complex and life-disrupting condition affecting about a quarter million Americans. 1 Its incidence varies widely from country to country, but~12 000 new cases are reported each year in the United States, with a recent increase most likely associated with present military conflicts. 2,3 SCI is the result of a trauma at any level of the spinal cord causing temporary or permanent damage. Motor vehicle accidents, falls and gunshot wounds are some of the most common causes of SCI among the civilian population, responsible for 39%, 28% and 14% of cases, respectively. 3 Individuals with SCI are at high risk for both community-acquired and healthcare-associated infections due to factors such as frequent contact with the healthcare system and frequent and chronic use of invasive medical devices such as urinary and intravascular catheters. 4,5 This population is also vulnerable by limitations in clearing the airway of secretions due to restricted breathing, and abnormal sensation leading to altered or absent symptoms to indicate early infection. Bloodstream infection (BSI) is one of the most common infections leading to hospital admission, followed by urinary tract infection ...

“…Colonization of multiresistant organisms in individuals with spinal cord lesions has been associated with neuropathic bladder, bladder management method (particularly indwelling catheterization), high rates of antibiotic use, mechanical ventilation and pressure ulcers. 23,[25][26][27][28] Precise identification is not only important to interpret the significance of the culture result, but also for interpretation of relapse or chronic/ biofilm infection. 17,29 The antibiogram can also be used in revealing reinfection, relapse or chronic/biofilm infection.…”

Section: Signs and Symptoms Of Utimentioning

confidence: 99%

International Spinal Cord Injury Urinary Tract Infection Basic Data Set

et al. 2013

Objectives: To develop an International Spinal Cord Injury (SCI) Urinary Tract Infection (UTI) Basic Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on UTIs in daily practice or research. Setting: International working group. Methods: The draft of the Data Set developed by a working group was reviewed by the Executive Committee of the International SCI Standards and Data Sets, and later by the International Spinal Cord Society (ISCoS) Scientific Committee and the American Spinal Injury Association (ASIA) Board. Relevant and interested scientific and professional (international) organizations and societies (B40) were also invited to review the data set, and it was posted on the ISCoS and ASIA websites for 3 months to allow comments and suggestions. The ISCoS Scientific Committee, Executive Committee and ASIA Board received the data set for final review and approval. Results: The International SCI UTI Basic Data Set includes the following variables: date of data collection, length of time of sign(s)/ symptom(s), results of urine dipstick test for nitrite and leukocyte esterase, urine culture results and resistance pattern. The complete instructions for data collection and the data form itself are freely available on the website of ISCoS (http://www.iscos.org.uk).