MP46-09 RISK OF URINARY TRACT INFECTION AFTER INTRADETRUSOR BOTULINUM TOXIN A INJECTION IN CATHETER-DEPENDENT PATIENTS WITH NEUROGENIC BLADDER WITH ASYMPTOMATIC BACTERIURIA

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I (MP46)1 Apr 2020MP46-09 RISK OF URINARY TRACT INFECTION AFTER INTRADETRUSOR BOTULINUM TOXIN A INJECTION IN CATHETER-DEPENDENT PATIENTS WITH NEUROGENIC BLADDER WITH ASYMPTOMATIC BACTERIURIA Alyssa Greiman*, Giulia Lane, Rachel Bergman, Paholo Barboglio Romo, J. Quentin Clemens, Priyanka Gupta, Diana O'Dell, John Stoffel, and Anne P. Cameron Alyssa Greiman*Alyssa Greiman* More articles by this author , Giulia LaneGiulia Lane More articles by this author , Rachel BergmanRachel Bergman More articles by this author , Paholo Barboglio RomoPaholo Barboglio Romo More articles by this author , J. Quentin ClemensJ. Quentin Clemens More articles by this author , Priyanka GuptaPriyanka Gupta More articles by this author , Diana O'DellDiana O'Dell More articles by this author , John StoffelJohn Stoffel More articles by this author , and Anne P. CameronAnne P. Cameron More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000901.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is not well known if asymptomatic bacteriuria (ASB) at the time of botox injection increases the risk of post-procedure urinary tract infections (UTI) in catheter-dependent patients with neurogenic bladder. We aim to determine the incidence of symptomatic UTI in patients with neurogenic bladder who undergo detrusor botox injection and to determine if asymptomatic bacteriuria increases this risk. METHODS: As part of an ongoing prospective study, we obtained urine cultures and urologic history from 43 asymptomatic patients with a diagnosis of neurogenic bladder who managed their bladder with intermittent catheterization or suprapubic catheter before they underwent intradetrusor botox injection. Each patient received a single dose of prophylactic antibiotics at the time of their procedure. We then followed these patients to determine if they developed a symptomatic UTI after their procedure. RESULTS: Of the 43 patients enrolled, 53.5% were women and the mean age was 52 years (19-78 years). Most had neurogenic bladder due to spinal cord injury (58.1%) or multiple sclerosis (14%). Most patients performed intermittent catheterization (91%), while the remainder had a suprapubic catheter. Urine cultures among these asymptomatic patients were positive in 79.1% (n=34). Two patients had a symptomatic UTI during the first week after botox (at 1 and 3 days post-procedure). This resulted in an overall risk of a symptomatic UTI of 4.7% in the entire population and a risk of 5.9% if ASB was present. Both patients who developed a symptomatic UTI after botox had ASB prior to the procedure with cultures growing two organisms (one with 10-100K CFU Enterococcus spp. plus 10-100k CFU E. coli and one with 10-100K CFU Enterococcus spp. plus 1-10K CFU Klebsiella pneumoniae). One patient’s pre-procedure antibiotic did not cover the Enterococcus in the urine. Symptoms were mild and included nausea, and chills with increased odor to the urine. CONCLUSIONS: The rate of symptomatic UTI after intradetrusor botox injections was 4.7% overall and 5.9% in catheter-dependent patients with neurogenic bladder who had asymptomatic bacteriuria at time of procedure. The presence of ASB at time of botox injection did not result in an increased risk of symptomatic UTI when compared to the available literature. It may not be necessary to screen the urine of this population prior to intradetrusor botox injections if they are asymptomatic. More data is needed to determine risk factors for developing a UTI after botox in this population. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e676-e677 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alyssa Greiman* More articles by this author Giulia Lane More articles by this author Rachel Bergman More articles by this author Paholo Barboglio Romo More articles by this author J. Quentin Clemens More articles by this author Priyanka Gupta More articles by this author Diana O'Dell More articles by this author John Stoffel More articles by this author Anne P. Cameron More articles by this author Expand All Advertisement PDF downloadLoading ...