Pseudomonas colonization in patients with spinal cord injury.

Pseudomonas has been an important cause of urinary tract infection in patients with spinal cord injuries. To determine the possible reservoirs of Pseudomonas, colonization with Pseudomonas was studied in 52 inpatients and 28 outpatients with spinal cord injuries. Body sites, the environment, and hospital staff were cultured. There was a high prevalence of colonization of the urethra, perineum, and rectum. Pseudomonas was isolated from one or more of these sites in 85% of male inpatients and in 71% of male outpatients. Significant bacteriuria with Pseudomonas was found in 37% of inpatients and 13% of male outpatients. Urethral colonization in men was significantly associated with the use of the external urethral catheter. Culturing the patient's perineum was a sensitive indicator of patient colonization. The urinary drainage bag was another frequent reservoir of Pseudomonas. More than one-half of these patients did not have significant bacteriuria and presumably the drainage bag was colonized from the urethra or perineum. The rates of urethral, perineal, and rectal carriage were higher than those described previously. These rates may be accounted for by the use of the external urethral catheters. Other factors, such as rectal manipulation, and fecal incontinence may be important in these groups of patients.