Catheter-associated urinary tract infections in persons with neurogenic bladders

Indwelling catheters are frequently used for bladder management after spinal cord injury, but they increase the risk of urinary tract infections. Preventing bladder overdistension and maintaining a healthy bacterial balance are crucial to minimize this risk. Judicious use of antibiotics is important because overuse can lead to antibiotic-resistant organisms. Alternative prevention and treatment strategies involve targeting the infection, modifying the bladder environment, and altering bacterial characteristics. New research suggests urine is not sterile and bladder colonization may play a role in preventing pathogenic bacteria from colonizing the bladder. The Human Microbiome Project found that each person has a unique microbiome.

• 1
  The incidence of UTI with indwelling urethral catheters was twice as high as for other types of management, emphasizing the importance of careful catheter management and judicious use of antibiotics in these individuals.
• 2
  The accuracy of self-predicting a UTI was 61%; 39% were not accurate at predicting they had a UTI, regardless of the level of their injury.
• 3
  Using expanded quantitative urine cultures, 80% grew bacterial species, showing that urine is not sterile.