Long-Term Pseudomonas Colonization in Spinal Cord Injury Patients

Abstract

In a previous study, patients with spinal cord injuries were observed to have a high incidence of colonizaion of the perineum, rectum, and urethra with Pseudomonas. In the current report, 10 men and 10 women with spinal cord injury were studied prospectively during their stay in hospital between June-Dec. 1977 (men) and Jan.-Nov. 1978 (women). Colonization seen in men (9/10 men: 14 episodes) was significantly more frequent than colonization in women (3/10 women: 5 episodes). Pseudomonas persisted in two or three sites for up to 105 days (mean 47 days) and serotyping showed that colonization was constant with one or two serotypes. Initial colonization occurred most frequently in the perineum and/or rectum. Colonization of the perineum was significantly more frequent than colonization of the rectum or urethra in men. Fifteen episodes of bacteriuria occurred only after (or with) colonization of perineum, urethra, and rectum. Rates of urethral colonization with Pseudomonas were higher in patients with external condom catheters than patients not using the external codon catheter. Urethral and perineal colonization usually resulted in colonization of the drainage bags even when these patients did not have significant bacteriuria. These drainage bags may be an important potential source of Pseudomonas for nosocomial infection. These studies indicate that Pseudomonas infections of the urinary tract may be prevented if acquisition of this pathogen in the perineum and/or rectum can be avoided.

Evaluation of Hospital Acquired Pseudomonas Infection in Paraplegic and Orthopaedic Cases

“…The increase in isolation of Pseudomonas aeruginosa at 29.9 per cent amongst SCIC and Orthopaedic cases corroborates with the study of Mongomerie and Morrow [14]. Although Pseudomonas is not a part of the body flora, studies [15] have found high prevalence of colonisation of the urethra, perineum and rectum associated with urinary tract infection in spinal cord injury patients.…”

Bacteriology of pressure ulcers in individuals with spinal cord injury: What we know and what we should know

“…43 In particular, the perineal region in individuals with SCI is more likely to become colonized with Pseudomonas and Klebsiella, with rates of colonization ranging from 20 to 80%. 40,[44][45][46][47][48] Colonization with Klebsiella has been shown to persist as long as 55 days and for Pseudomonas, 120 days during hospitalization. 45,49 These prior described changes in skin flora may be anticipated to affect the bacterial composition of pressure ulcers in individuals with SCI.…”

“…40,[44][45][46][47][48] Colonization with Klebsiella has been shown to persist as long as 55 days and for Pseudomonas, 120 days during hospitalization. 45,49 These prior described changes in skin flora may be anticipated to affect the bacterial composition of pressure ulcers in individuals with SCI. Overall changes in the bacteria isolated from chronic pressure ulcers may reflect changes in the microbiome of the skin.…”

Retrospective Analysis of Nosocomial Urinary Tract Infections with Spinal Cord Injury Patients in a Rehabilitation Setting

“…Amikacin and gentamicin are not commonly used antibiotics because of their potential nephrotoxicity, which might be a cause for this result. Previous studies have focused on the antibiotic resistance of P. aeruginosa (15)(16)(17)(18)(19) or K. pneumoniae in patients with SCI (16,(19)(20)(21)(22). Although Klebsiella was the second most common uropathogen seen in our SCI patients, its distribution was not significantly different between acute and chronic patients.…”