Causative Agents and their Antimicrobial Susceptibilities of Catheter-related Urinary Tract Infection among Spinal Cord Injury or Disorder Patients

Abstract

Abstract Background and Objectives: Complicated urinary tract infections (UTIs) are often difficult to treat because of the existence of isolated antibiotic-resistant strains. Impaired bladder emptying is present in around 60% of spinal cord injuries or disorders patients. The objective of the study was to find the causative agents and their antimicrobial susceptibilities of catheter-related UTIs. Methods: The study was conducted among 160 subjects from Calicut District, Kerala, India using the purposive sampling method. From this, 89 were using intermittent and 71 were using indwelling catheterization. UTI was assessed by urine culture and sensitivity test from NABL accredited laboratory. Statistical Analysis Used: The association between demographic and clinical variables was performed using the Chi-square test. P < 0.05 was considered statistically significant. Results: The study consisted of 160 spinal cord injuries or disorders patients with a mean age at which injury occurred was 35.66 ± 12.78. For the detection of UTIs, culture and sensitivity of urine were done. Out of them, 115 (72%) had UTIs. Escherichia coli was the most common causative agent of UTI 55 (47.8%), followed by Klebsiella 33 (28.6%), Pseudomonas 9 (7.8%), and Proteus vulgaris 7 (6.3%). The study showed that the most resistant antimicrobial agents for E. coli were ampicillin 39 (71%), amoxicillin and potassium clavulanate 32 (58%), and cefuroxime oral. Less resistant antimicrobial agents to E. coli were doxycycline 12 (21%), cefepime 13 (24%), and gentamicin 16 (29%). The most resistant antimicrobial agents to Klebsiella were ampicillin 33 (100%) and nitrofurantoin 23 (70%). Conclusion: UTI is one of the most common complications among spinal cord injuries or disorders patients using a catheter for bladder emptying. Appropriate antibiotics should be prescribed to treat UTIs and to avoid antimicrobial resistance.