Togan Turhan, Azap Ozlem Kurt, Durukan Elif, Arslan Hande
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Baskent University, Ankara, Turkey.
Department of Public Health, Baskent University Faculty of Medicine, Ankara, Turkey.
Jundishapur J Microbiol. 2014 Jan;7(1):e8905. doi: 10.5812/jjm.8905. Epub 2014 Jan 1.
Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days.
The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury.
This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria.
Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant.
The most common infectious episode among spinal cord injury patients was found to be urinary tract ınfection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract ınfection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection.
尿路感染（UTIs）是脊髓损伤患者发病和死亡的重要原因，22%的急性脊髓损伤患者在最初50天内会发生尿路感染。
本研究旨在确定脊髓损伤患者无症状菌尿和有症状尿路感染的患病率、病原体及危险因素。
这是一项对2008年1月至2010年12月间在巴斯肯大学医学院阿亚斯康复中心和安卡拉物理治疗与康复中心的脊髓损伤患者进行的无症状菌尿和有症状尿路感染的前瞻性调查。分析了93例脊髓损伤患者的人口统计学状况、临床和实验室检查结果，以确定无症状或有症状菌尿的危险因素。
93例患者中，63例（67.7%）有无症状菌尿，21例（22.6%）有症状尿路感染。对膀胱排空方法的使用频率评估显示，93例患者中有57例（61.3%）使用永久性导尿管，24例（25.8%）使用清洁间歇性导尿。从无症状菌尿发作中分离出的281株菌株中有135株（48.0%），从有症状尿路感染发作中分离出的24株菌株中有16株（66.6%），共计151株具有多重耐药性（P>0.05）。无症状菌尿患者中，142株大肠杆菌中有100株（70.4%）、55株克雷伯菌属中有19株（34.5%）增殖；10株大肠杆菌中有8株（80%）、5株克雷伯菌属中有4株（80%）具有多重耐药性。
脊髓损伤患者中最常见的感染事件是尿路感染。大肠杆菌是从尿液样本中分离出的最常见微生物。前2周或3个月内使用抗生素、过去一年住院以及既往尿路感染诊断是多重耐药菌株感染发生的危险因素。导尿被发现是导致有症状尿路感染的唯一独立危险因素。
