Korean J Urol.  2011 May;52(5):345-349.

Results of Urine Culture and Antimicrobial Sensitivity Tests According to the Voiding Method Over 10 Years in Patients with Spinal Cord Injury

• Ryu KH
• Kim YB
• Yang SO
• Lee JK
• Jung TY

Abstract

PURPOSE
We studied the results of urine cultures and antimicrobial sensitivity tests according to the voiding method used by spinal cord injury (SCI) patients over a recent 10-year period.
MATERIALS AND METHODS
We retrospectively analyzed 1,236 urine samples and their antimicrobial sensitivity tests for 112 patients who had used only one voiding method between January 2000 and December 2009. The voiding methods were classified into four groups: clean intermittent catheterization (CIC), suprapubic catheterization, urethral Foley catheter, and spontaneous voiding.
RESULTS
Of the 1,236 urine samples, 925 (74.8%) were positive and 279 (30.2%) had more than one bacteria. The CIC group showed the lowest rate of bacteriuria, colony counts, and polymicrobial infection (p<0.001). Causative organisms were mostly Gram-negative bacteria (84%), including Pseudomonas aeruginosa (22.9%), Escherichia coli (21.1%), Klebsiella species (6.7%), and Citrobacter species (6.3%). The rate of Gram-positive bacterial infection was 13.6%, and major pathogenic organisms were Streptococcus species (8.6%) and Staphylococcus species (2.6%). Major pathogenic organisms and the results of antimicrobial sensitivity tests differed according to the voiding method.
CONCLUSIONS
Although the patient's condition and preferences are important when choosing the method of bladder management, CIC is the best voiding method for reducing urinary tract infections in SCI patients. When immediate use of antibiotics is needed for treatment of urinary tract infections, an appropriate antibiotic can be chosen according to the voiding method on the basis of our study and can be administered before the results of an antimicrobial sensitivity test are available.

Keyword

Bacteriuria; Microbial sensitivity tests; Spinal cord injuries; Urinary tract infections

MeSH Terms

Anti-Bacterial Agents
Bacteria
Bacteriuria
Catheters
Citrobacter
Coinfection
Escherichia coli
Gram-Negative Bacteria
Gram-Positive Bacterial Infections
Humans
Intermittent Urethral Catheterization
Klebsiella
Microbial Sensitivity Tests
Pseudomonas aeruginosa
Retrospective Studies
Spinal Cord
Spinal Cord Injuries
Staphylococcus
Streptococcus
Urinary Bladder
Urinary Catheterization
Urinary Tract Infections
Anti-Bacterial Agents

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