Clinico-microbiological profile of urinary tract infections in hospitalized spinal cord injury patients

Abstract

BACKGROUND: Hospitalized spinal cord injury (SCI) patients are predisposed to develop nosocomial infections owing to a variety of risk factors, and treatment of such infections is usually suboptimal. AIMS: We aimed to evaluate the prevalence of urinary tract infection (UTI) in hospitalized SCI patients along with their clinical profile, prevailing uropathogens, and their antibiotic sensitivity patterns. SETTING AND DESIGN: This is a cross-sectional, analytical study carried out at a tertiary military center specialized in management of SCI. MATERIALS AND METHODS: Fifty-two admitted patients of SCI were selected, whose clinical profiles including times since injury and since present admission, level of spinal injury, American Spinal Injury Association scale, urinary or fecal incontinence, and mode of bladder emptying were assessed, and sterile midstream urine samples were subjected to cytological and microbiological examination inclusive of antibiotic sensitivity testing using VITEK 2 (bioMerieux®, France) automated system. STATISTICAL ANALYSIS USED: Comparisons were made for each variable using Chi-square test. RESULTS: The prevalence of UTIs in our cohort was 67.31% (35/52 patients). Statistically significant differences were found in development of UTI in the presence of a neurogenic bladder, fecal incontinence, usage of clean intermittent catheterization as mode of bladder emptying, pyuria, and increased length of hospital stay (P CONCLUSION: UTI in SCI patients is often mismanaged owing to unnecessary or faulty empirical antibiotic institution. We have tried to provide a systematic antibiotic protocol for management of this oft encountered entity.