Bacterial infections in patients with chronic renal failure: occurrence with spinal cord injury

The available data were examined from 43 patients with spinal cord injuries and end-stage renal disease undergoing dialysis. All but one patient had a chronic urinary tract infection, which was characterized by persistence of the same organisms for prolonged periods, high prevalence of mixed infections, scarcity of symptoms, lack of fever of leukocytosis, and a considerable prevalence of cross-infection with the decubitus ulcers. Staphylococcus aureus and various Gram-negative organisms were responsible for most of the vascular access infections in our patients. Decubitus ulcers were common and were frequently infected. Cross-contamination between infected decubitus ulcers, the urinary tract, and vascular access seemed to have occurred on several occasions. The recorded respiratory infections were preponderantly caused by Gram-negative organisms. Urinary tract, vascular access, and decubitus infections seemed to be the source of septicemia in most of the recorded instances. Septicemia was the immediate cause of death in half of the patients.