Article

Non-interventional, descriptive-observational cohorts
study.Objectives:To assess the incidence of urinary tract infection (UTI) after
urodynamic examination in patients with spinal cord injury (SCI) according to
bladder management.Setting:Level 1 trauma centerMethods:Between January and
December 2010 a total of 133 consecutive, hospitalized SCI patients were included
and classified according to their bladder management. Urine specimen was obtained
at the beginning of the urodynamic studies (UDS) and 3-5 days thereafter.
'Significant bacteriuria' (SBU) is defined by a CBU per ml level >/=10(5) in a
urine culture. UTI thus is defined as a combination of a SBU and >/=100
leukocytes per mul in urine analysis.Results:The overall incidence of UTI post
UDS was 15.79%. In patients with sterile urine prior to urodynamics UTI was
ascertained in 8.6% (de-novo-UTI). In contrast, 32.5% of the patients with SBU
prior to UDS showed UTI 3 days later. There were only minor differences in the
incidence of de-novo-UTIs in SCI patients who emptied their bladder by
intermittent self catheterization or intermittent catheterization by attendant
(8.82% and 6.67%, respectively). In SCI patients with reflex voiding however, the
frequency of de-novo-UTIs was twice as high (14.28%).Conclusion:The
recommendation of antibiotic prophylaxis for all SCI patients undergoing
urodynamic examination is not commonly accepted and according to our data not
justified. However, the analysis of subgroups revealed that SCI patients with
unsuspected SBU prior to UDS and patients with reflex voiding are possibly at
higher risk to acquire post-UDS infection.

Langue : ANGLAIS