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

Abstract

Objective: To define the distribution and antibiotic susceptibility of nosocomial urinary tract infections (NAUTIs) in patients with spinal cord injury (SCI). Material and Methods: Records of the spinal cord injured patients were reviewed for NAUTIs between 2008 and 2010. Antibiotic resistance rates and factors that might affect urinary tract infection susceptibility were investigated retrospectively. Results: The data of 276 patients were included, of whom 159 were acute SCI patients and 117 were chronic SCI patients; 166 (61%) infections were asymptomatic bacteriuria (ASB), and 110 (39%) infections were symptomatic urinary tract infections (SUTIs). In patients with acute SCI, E. coli was the most frequently isolated pathogen of SUTIs, followed by Pseudomonas. In patients with chronic SCI, E. coli was the most frequently isolated pathogen in SUTIs and ASBs. There was no statistically significant difference in the rates of NAUTI (ASB and SUTI) between acute and chronic SCI patients in terms of bladder drainage method. The susceptibility ratios for E. coli were very low in both acute and chronic SCI patients using Foley catheters. Although the susceptibility ratios for E. coli were not that low in SCI patients using clean intermittent catheterization, the resistance ratios were higher than 50% for most of the uropathogens. Conclusion: These results reveal a blunt truth that the treatment of NAUTIs will be a great challenge in near future. Kronik SKY hastalarda SUTI ve ASB için en sık izole edilen patojen E. coli idi. Mesane boşaltım yöntemi dikkate alındığında, akut ve kronik SKY hastalar arasında NAUTI (ASB ve SUTI) dağılımı açısından anlamlı bir fark yoktu. Foley kateter kullanan akut ve kronik SKY hastalarda E. coli duyarlılık oranları çok düşüktü. Temiz aralıklı kateterizasyon uygulanan hastalarda duyarlılık oranları o kadar düşük olmasa da, direnç oranları üropatojenlerin çoğu için %50'nin üzerindeydi. Sonuç: Bu sonuçlar, nozokomiyal üriner sistem infeksiyonlarının tedavisinin yakın gelecekte ne kadar büyük bir sorun olacağı konusundaki gerçeği ortaya koymaktadır. Anahtar Kelimeler: Spinal kord yaralanması, nozokomiyal üriner sistem infeksiyonu, rehabilitasyon

Nosocomial Urinary Tract Infections, and Their Susceptibility to Antimicrobial Agents in Spinal Cord Injury Patients at a Rehabilitation Setting

“…The difference between acute and chronic SCI patients in rates of NAUTI (ASB and SUTI) in terms of bladder drainage method was statistically insignificant. Susceptibility ratio for E.coli in patients of acute and chronic SCI using Foley catheter was very low; however it was not that low in patients using clean intermittent catheterization 22 . Another study had 91 SCI patients with 53 males and 38 females having mean age of of 45.29 ± 17.87 years.…”

“…Also, it showed that type of bacteria and its response to various antibiotics can be different in different settings. Also, bacteria may acquire resistance to the antibiotics being used in a particular set up 7 .…”