Study of Prevalence, Microbiologic Agents, and Bladder Management Methods of Urinary Tract Infections among Spinal Cord Injury Patients

Abstract

Background and Aim: Spinal cord injury (SCI) patients have an increased risk of developing urinary tract infections. The method of bladder drainage influences the risk of urinary tract infection (UTI), and most persons with SCI on per urethral continuous catheterization (CC) or clean intermittent catheterization (CIC) develop urinary tract infection. Identification and treatment of severe UTI with appropriate antibiotics as early as possible is associated with better outcomes in SCI patients. The aim of this study was to determine the prevalence and causative organisms of symptomatic urinary tract infection in spinal cord injury patients with different bladder management methods. Materials and Methods: A total of 50 patients with SCI were followed up at a rehabilitation centre from Jan 2020 to Dec 2021 in a prospective descriptive study. The demographic status, clinical and laboratory findings of the patients with SCI were studied and the prevalence and causative organisms of symptomatic UTI in these patients with different bladder management methods were analysed. Results: The commonest organisms isolated were E. coli (31%), Pseudomonas (29%) and Klebsiella (21%). The organisms isolated in the UTI were most sensitive to colistin (82%), followed by 59% being sensitive to both imipenem and tigecycline. Least sensitivity was seen to Piperacillin, Ceftriaxone and Levofloxacin. Maximum UTI episodes were seen in cases with CC followed by CIC. Least UTI episodes were seen in cases where supra-pubic cystostomy was done followed by patients who were self-urinating. Conclusion: Symptomatic UTI in SCI patients is more prevalent in patients with CC and CIC. Such patients should be started as early as possible on antibiotics depending on the antibiotic sensitivity pattern of the organisms isolated.