[Urinary tract infection in patient after brain injury]

One of the most important problems in treating patients after head injury is urinary complication. The first place take urinary infections, which disturb rehabilitation process. Clean intermittent catherization, bladder training and good care do not preserve infection. The purpose of our study was to present the frequency of urinary infections and main pathogens involved in these infections among patients treated in The Department of Rehabilitation after head injury.

We gathered microbiological tests and observations from 398 patients (from 2 to 73 years old) after head injury treated in years 2003-2005. Some of them survived head injury and some of them had also multiorgan injury.

In 133 of them we found bladder and urethra infections, vesical calculus in 11 cases. In one case we found prostatic abscessus and in one case urethroscrotal fistula. Each patient had microbiological test of urine after he was admitted to the Department. If the test was positive he had pharmacological treatment. In 157 urinary infections we selected Proteus sp., Pseudomonas aeruginosa, Escherichia coli, Klebsiella sp., Enterococcus sp., Acinetobacter sp. Serratia marcescens, Morganella morganii, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae and Candida albicans was represented not so often.

The most frequent pathogens were: Proteus mirabilis, Pseudomonas aeruginosa, E. coli. Most of patients had positive microbiological tests at the admittance to our Department. These complications extend the rehabilitation process and generate high costs. It is necessary to create standards of care of neuropathic bladder in patients after head injury.