Urinary tract infection analysis in a spinal cord injured population undergoing rehabilitation--how to treat?

Cross sectional study, including 38 outpatients. Standardized questionnaire was used and urine cultures were performed.

To study spinal cord-injured (SCI) patients bladder management, clinical aspects that symptomatic urinary tract infection (SUTI) may present and asymptomatic bacteriuria (AB) incidence with its antimicrobial susceptibility profile.

Spinal cord injury outpatient rehabilitation clinic.

Clean intermittent catheterization is used by 71% of the patients. SUTI may have atypical clinical presentation (shivers, spasticity increase, headaches). In total, 65.7% (N=25) of the patients presented AB. Among these, the microorganisms isolated were resistant mainly to Ampicillin, Sulfamethoxazole-Trimethoprim and Norfloxacin, whose resistance rates were, respectively 73.3%, 60% and 33.3%.

Special attention should be given to possible atypical symptoms for SUTI. Although a small amount of urine samples was analyzed, resistance rates against Ampicillin, Sulfamethoxazole-Trimethoprim, Ciprofloxacin and Nitrofurantoin appear to be higher among SCI patients compared to the general population, thus demonstrating the need for continuous monitoring of microorganisms susceptibility, in order to avoid therapeutic failure when dealing with this specific population.