Retrospective Analysis of Nosocomial Urinary Tract Infections with Spinal Cord Injury Patients in a Rehabilitation Setting

Abstract

Objective: To define the distribution and antibiotic susceptibility of nosocomial urinary tract infections (NAUTIs) in patients with spinal cord injury (SCI). Material and Methods: Records of the spinal cord injured patients were reviewed for NAUTIs between 2008 and 2010. Antibiotic resistance rates and factors that might affect urinary tract infection susceptibility were investigated retrospectively. Results: The data of 276 patients were included, of whom 159 were acute SCI patients and 117 were chronic SCI patients; 166 (61%) infections were asymptomatic bacteriuria (ASB), and 110 (39%) infections were symptomatic urinary tract infections (SUTIs). In patients with acute SCI, E. coli was the most frequently isolated pathogen of SUTIs, followed by Pseudomonas. In patients with chronic SCI, E. coli was the most frequently isolated pathogen in SUTIs and ASBs. There was no statistically significant difference in the rates of NAUTI (ASB and SUTI) between acute and chronic SCI patients in terms of bladder drainage method. The susceptibility ratios for E. coli were very low in both acute and chronic SCI patients using Foley catheters. Although the susceptibility ratios for E. coli were not that low in SCI patients using clean intermittent catheterization, the resistance ratios were higher than 50% for most of the uropathogens. Conclusion: These results reveal a blunt truth that the treatment of NAUTIs will be a great challenge in near future.