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Bacteremia in the spinal cord injury population
Abstract:
Positive blood cultures were found in 41 patients on the Spinal Cord Injury Service at the Milwaukee VAMC during the period of July, 1980 to December, 1985 giving an incidence of bacteremia of 1.3%. Mortality rate was 17%. Most common pathogens were E. Coli, Proteus mirabilis, Serratia marcescens and Staphylococcus aureus. A review of 29 available charts revealed genitourinary and respiratory tracts as the most common sources of infection (72.4% and 10.3% respectively). Other sources of infection were skin, postoperative, intravenous catheter site and cellulitis. Initial febrile response was seen in 93.1% of patients with 48.1% having temperature greater than 38.3 degrees C. Hypotension (blood pressure less than 90/50 mm Hg) was noted in five out of the 29 (17.1%) patients. Clinical diagnosis of disseminated intravascular coagulation was made in two out of the 29 (6.9%) patients. Underlying risk factors were poor nutrition, respirator dependency, indwelling Foley catheters and manipulative procedures. Incidence and mortality rates are similar to the non-SCI population as reported elsewhere. The risk factors are different; therefore preventive management is extremely important.
Insights
Bacteremia occurred in 1.3% of spinal cord injury patients, with common pathogens including E. coli. Unique risk factors highlight the need for targeted preventive management strategies.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Spinal cord injury (SCI) patients may have unique susceptibilities to infections.
- Understanding bacteremia incidence and sources in SCI populations is crucial for patient care.
Purpose of the Study:
- To determine the incidence, pathogens, sources, and outcomes of bacteremia in spinal cord injury patients.
- To identify risk factors associated with bacteremia in this population.
Main Methods:
- Retrospective chart review of patients on the Spinal Cord Injury Service from July 1980 to December 1985.
- Analysis of positive blood cultures, patient demographics, clinical data, and mortality.
Main Results:
- An incidence of 1.3% bacteremia was observed in 41 patients, with a 17% mortality rate.
- Common pathogens included E. coli, Proteus mirabilis, Serratia marcescens, and Staphylococcus aureus.
- Genitourinary (72.4%) and respiratory (10.3%) tracts were the most frequent infection sources. Risk factors included poor nutrition, respirator dependency, and indwelling catheters.
Conclusions:
- Bacteremia incidence and mortality in SCI patients are comparable to the general population.
- However, the risk factors for bacteremia in SCI patients differ significantly, necessitating tailored preventive strategies.
- Proactive management focusing on identified risk factors is essential for reducing bacteremia in SCI patients.