Significance of Bacteriuria in Neurogenic Bladder

Jayawardena, Vidya; Midha, Meena

doi:10.1080/10790268.2004.11753738

Cited by 34 publications

(12 citation statements)

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“…As to bladder sensory function, class A involves complete disability creating a situation where the patients do not notice excessive urine storage or urinary incontinence. Even though there are very few studies in this area, Jayawardena et al 23 reported class A is at risk for positive urine culture and bacteriuria. Our data showed ASIA class C or more severe significantly related with UTI occurrence and it can be interpreted as that class is more injured as to motor (muscle) function than class D so that it may lead to low bladder compliance and possibility of VUR.…”

Section: Discussionmentioning

confidence: 99%

Retrospective study for risk factors for febrile UTI in spinal cord injury patients with routine concomitant intermittent catheterization in outpatient settings

et al. 2015

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Study design: Retrospective study. Objectives: The objective of this study was to investigate the clinical risk factors for febrile urinary tract infection (UTI) in spinal cord injury-associated neurogenic bladder (NB) patients who perform routine clean intermittent catheterization (CIC). Setting: Rehabilitation Hospital, Kobe, Japan. Methods: Over a 3-year period, we retrospectively assessed the clinical risk factors for febrile UTI in 259 spinal cord injury patients diagnosed as NB and performing routine CIC with regard to the factors such as gender, the presence of pyuria and bacteriuria, and the categories of the American Spinal Injury Association (ASIA) impairment scale. Results: A total of 67 patients had febrile UTI in the follow-up period, with 57 cases of pyelonephritis, 11 cases of epididymitis and 2 cases of prostatitis, including the patients with plural infectious diseases. The causative bacteria were ranked as follows: Escherichia coli (74 cases), Pseudomonas aeruginosa (17 cases), Enterococcus faecalis (14 cases) and Klebsiella pneumoniae (12 cases). Antibiotic-resistant E. coli were seen, with 10.5% instances of extended-spectrum β-lactamase (ESBL) production and 23.8% of fluoroquinolone resistance. Multivariate analyses of clinical risk factors for febrile UTI showed that gender (male, P = 0.0431), and ASIA impairment scale C or more severe (P = 0.0266) were significantly associated with febrile UTI occurrence in NB patients with routine CIC. Conclusion: Our data demonstrated gender (male) and ASIA impairment scale C or more severe were significantly associated with febrile UTI occurrence in NB patients using routine CIC. Further prospective studies are necessary to define the full spectrum of possible risk factors for febrile UTI in these patients.

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Section: Discussionmentioning

confidence: 99%

Retrospective study for risk factors for febrile UTI in spinal cord injury patients with routine concomitant intermittent catheterization in outpatient settings

et al. 2015

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“…55,56 However, relapsing episodes of asymptomatic bacteriuria in SCI patients were associated with developing symptomatic UTI in one study. 57 This is further complicated by poor symptom assessment in this population, though clinical evaluation and laboratory findings remain useful in diagnosing true UTI in SCI patients.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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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 ...

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“…6 Infections are often polymicrobial and antibiotic resistant, and long-term antibiotic prophylaxis has not shown significant benefit. 7,8 Despite advances in the management of neurogenic bladder, UTI represents a leading cause of morbidity and hospitalization. 9 This trial was designed to evaluate the effects of cranberry tablets as a prevention of UTI in the adult spinal cord injury population with neurogenic bladder.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder

et al. 2008

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Study Design: Randomized, double blind, placebo-controlled trial with a crossover design. Objective: To evaluate cranberry tablets for the prevention of urinary tract infection (UTI) in spinal cord injured (SCI) patients. Setting: Spinal Cord Injury Unit of a Veterans Administration Hospital, MA, USA. Methods: Subjects with spinal cord injury and documentation of neurogenic bladder were randomized to receive 6 months of cranberry extract tablet or placebo, followed by the alternate preparation for an additional 6 months. The primary outcome was the incidence of UTI. Results: Forty-seven subjects completed the trial. We found a reduction in the likelihood of UTI and symptoms for any month while receiving the cranberry tablet (Po0.05 for all). During the cranberry period, 6 subjects had 7 UTI, compared with 16 subjects and 21 UTI in the placebo period (Po0.05 for both number of subjects and incidence). The frequency of UTI was reduced to 0.3 UTI per year vs 1.0 UTI per year while receiving placebo. Subjects with a glomerular filtration rate (GFR) greater than 75 ml min À1 received the most benefit. Conclusion: Cranberry extract tablets should be considered for the prevention of UTI in SCI patients with neurogenic bladder. Patients with a high GFR may receive the most benefit.

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Significance of Bacteriuria in Neurogenic Bladder

Cited by 34 publications

References 0 publications

Retrospective study for risk factors for febrile UTI in spinal cord injury patients with routine concomitant intermittent catheterization in outpatient settings

Retrospective study for risk factors for febrile UTI in spinal cord injury patients with routine concomitant intermittent catheterization in outpatient settings

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

Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder

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