Prevalence of and Risk Factors for Multidrug-Resistant Bacteria in Urine Cultures of Spinal Cord Injury Patients

Ann Rehabil Med, 2015 · DOI: http://dx.doi.org/10.5535/arm.2015.39.5.686 · Published: October 1, 2015

Spinal Cord Injury Pharmacology Immunology

Simple Explanation

Spinal cord injury (SCI) patients often experience urinary tract infections (UTIs) due to impaired bladder function and the use of indwelling catheters. Repeated UTIs and exposure to antibiotics increase the risk of colonization by multidrug-resistant (MDR) bacteria. The study analyzed data from SCI patients admitted to a rehabilitation hospital between 2001 and 2013 to determine the prevalence of MDR organisms in urine samples and identify factors that increase their occurrence. The study found an increasing trend of MDR organism isolation in SCI patients, particularly among inpatients and those using indwelling catheters. These findings highlight the importance of infection control measures in SCI patients to reduce the risk of MDR organism colonization.

Study Duration

2001 to 2013

Participants

2,629 urine samples from newly admitted SCI patients

Evidence Level

Not specified

Key Findings

1
Significant bacteriuria was identified in 73.4% of urine samples from newly admitted SCI patients, and MDR organisms were isolated in 1.1% of cultures.
2
There was an increasing trend of MDR organism prevalence from 2001 to 2013 (p<0.01).
3
Patients who used a suprapubic indwelling catheter (3.3%) or a urethral indwelling catheter (2.6%) showed a higher rate of MDR organism isolation (p<0.05).

Research Summary

This retrospective study analyzed urine culture results from 2,629 spinal cord injury (SCI) patients admitted between 2001 and 2013 to determine the prevalence of multidrug-resistant (MDR) organisms and associated risk factors. The study found a significant increase in MDR organism prevalence over the study period, with higher rates among inpatients and those using indwelling urinary catheters. Multivariate logistic regression analysis identified admission year and urethral indwelling catheter use as significant risk factors for MDR organism isolation, highlighting the need for improved infection control practices in SCI patients.

Practical Implications

Infection Control

Emphasis on stringent infection control protocols in rehabilitation centers, especially for SCI patients using indwelling catheters.

Catheter Management

Reevaluation of indwelling catheter use and exploration of alternative bladder management methods to minimize MDR organism colonization.

Surveillance and Monitoring

Continuous monitoring of MDR organism prevalence to detect changes in yearly trends and inform appropriate treatment strategies.

Study Limitations

1
Single-institutional study limiting generalizability.
2
Retrospective design relying on patient charts.
3
Lack of data on clinical symptoms, antibiotic usage, and prior hospitalization details.

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