MP26-01 INCONSISTENCY IN THE DEFINITION OF URINARY TRACT INFECTION IN THE SPINAL CORD INJURY POPULATION: A SYSTEMATIC REVIEW

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2016MP26-01 INCONSISTENCY IN THE DEFINITION OF URINARY TRACT INFECTION IN THE SPINAL CORD INJURY POPULATION: A SYSTEMATIC REVIEW Laura L. Giusto, Yahir Santiago-Lastra, Michael V. Hughes, Mark MacEachern, and Anne P. Cameron Laura L. GiustoLaura L. Giusto More articles by this author , Yahir Santiago-LastraYahir Santiago-Lastra More articles by this author , Michael V. HughesMichael V. Hughes More articles by this author , Mark MacEachernMark MacEachern More articles by this author , and Anne P. CameronAnne P. Cameron More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2938AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary tract infection (UTI) is a commonly reported outcome in Spinal Cord Injury (SCI) literature. In the early 1990s, the National Institute on Disability and Rehabilitation Research (NIDRR) consensus conference recommended a standard definition of UTI in the SCI patient utilizing urine culture data, urinalysis and clinical symptoms including fever. Despite this proposed definition, there is considerable variability in the way UTIs are defined in SCI literature. Our aim is to report the inconsistency in UTI definitions in the existing SCI literature. METHODS We performed a systematic review using the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. We conducted a query of Embase and Medline, using the medical subject heading terms ′′spinal cord injury′′ and ′′urinary tract infections.′′ We included studies that reported on SCI patients as study subjects and had a UTI outcome reported. RESULTS We identified 1425 publications of which 317 met inclusion criteria. UTI was reported as a primary outcome in 254 (80.13%) of included articles, however only 139 (43.85%) of included studies provided an explicit definition of UTI (Table 1). We encountered eleven different definitions of UTI. Positive urine culture, urinalysis, fever and clinical symptoms defined a UTI in 52 (37.41%) of 139 studies. Despite using these four criteria, most of these studies did not specifically describe using the NIDRR definition of UTI. RCTs were more likely to define a UTI than other study types (X2= 12.77, n=39, p < 0.05). Sixty-four (20.32%) of the included articles were published in urology journals versus non-urology journals. Articles published in urology journals did not have an increased likelihood that UTI would be defined (X2= 0.213, p = 0.65). Articles published after the 1992 NIDDR consensus conference were no more likely to report a definition of UTI (X2= 1.39, p = 0.24). CONCLUSIONS Definitions for UTI are variable and used inconsistently in studies of SCI patients, limiting the reliability of its diagnosis in this population. Despite various proposed definitions over time, there has not been a consistently established definition of UTI in SCI literature. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e353-e354 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Laura L. Giusto More articles by this author Yahir Santiago-Lastra More articles by this author Michael V. Hughes More articles by this author Mark MacEachern More articles by this author Anne P. Cameron More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...