Related Experiment Videos
Low mortality among patients with spinal cord injury and bacteremia
J Z Montgomerie1, E Chan, D S Gilmore
1University of Southern California School of Medicine, Los Angeles.
Abstract:
We reviewed 103 episodes of bacteremia in 93 patients with spinal cord injury who had bacteremia during initial hospitalization (39 patients) or readmission (54 patients) during 1978-1988. Eighteen episodes (18%) were due to polymicrobial infections. Urinary tract infections (47%), infected pressure areas (19%), and pneumonia (9%) were the most frequent primary infections and sources of the bacteremia. The bacteria most frequently associated with urinary tract infections were enterococci (26%), Escherichia coli (26%), Pseudomonas species (20%), and Klebsiella pneumoniae (12%). Bacteria most frequently isolated from patients with infected pressure areas were anaerobes and Staphylococcus aureus. Bacteremia was the cause of death for 8 patients (9%). The urinary tract was identified only once as the source of gram-negative bacteremia in an immunocompetent patient who died. The reason for the low mortality in patients with spinal cord injury is unclear.
Insights
Bacteremia in spinal cord injury patients often originates from urinary tract infections or pressure sores. Despite frequent infections, mortality from bacteremia in this population remains surprisingly low.
Area of Science:
- Infectious Diseases
- Neurology
- Critical Care Medicine
Background:
- Spinal cord injury (SCI) patients face increased risks for infections, including bacteremia.
- Understanding common sources and causative agents of bacteremia is crucial for managing SCI patients.
- Previous studies on bacteremia in SCI populations have varied in scope and focus.
Purpose of the Study:
- To investigate the epidemiology of bacteremia in patients with spinal cord injury.
- To identify the primary sources and common pathogens associated with bacteremia in SCI.
- To analyze the mortality rates and potential contributing factors in SCI patients with bacteremia.
Main Methods:
- Retrospective review of 103 bacteremia episodes in 93 spinal cord injury patients.
- Data collected from initial hospitalization and readmissions between 1978 and 1988.
- Analysis of primary infection sources, causative microorganisms, and patient outcomes.
Main Results:
- Urinary tract infections (47%), infected pressure areas (19%), and pneumonia (9%) were the most common sources of bacteremia.
- Common pathogens included Enterococci, Escherichia coli, Pseudomonas species, Klebsiella pneumoniae, anaerobes, and Staphylococcus aureus.
- Bacteremia caused death in 9% of cases; the low overall mortality warrants further investigation.
Conclusions:
- Urinary tract infections are the leading source of bacteremia in spinal cord injury patients.
- Polymicrobial infections were observed in 18% of episodes.
- The low mortality rate from bacteremia in SCI patients is notable and requires further study.