Department of Urologic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Can J Urol. 2021 Dec;28(6):10920-10928.
Urinary Tract Infection (UTI) has been cited as the primary cause of morbidity in patients with history of spinal cord injury (SCI). Despite the significance of recurrent UTI (rUTI) in this population, the causative physiologic and patient characteristics are not well described. We sought to assess associations between demographic, clinical and urodynamic variables and rUTI.
The records of 136 individuals with SCI who perform clean intermittent catheterization (CIC) were retrospectively reviewed. All had a video urodynamics study (VUDS) available for analysis. Individuals were divided into non-recurrent (< 3/year) or rUTI (≥ 3/year) groups. Differences between the cohorts were analyzed. Multivariable logistic regression was performed to determine associations between various demographic, clinical, and VUDS variables and rUTI.
Self-reported rUTI were noted in 58 of 136 individuals. Of 124 individuals with urinary culture results, African American race (43.3% vs. 22.3%) and 'Other' race (13.3% vs. 8.5%) made up larger proportions in the rUTI group. Female gender (OR 4.96, 95% CI [1.44-17.13]) and African American race (OR 5.16, 95% CI [1.80-14.79]) were increasingly associated with rUTI on multivariable logistic regression. Shorter interval since injury was also significantly associated with recurrent infections with each year since injury indicating diminished likelihood (OR 0.91, 95% CI [0.82-0.99]). There were no significant differences in VUDS variables between groups and none were significant on regression as potential determinants of rUTI.
Patient race, gender, and time since SCI appear to have significant associations with rUTI in individuals with SCI using CIC. However, VUDS variables were not found to be significantly associated with rUTI.
尿路感染（UTI）已被认为是脊髓损伤（SCI）病史患者发病的主要原因。尽管复发性尿路感染（rUTI）在这一人群中意义重大，但导致其发生的生理和患者特征尚不清楚。我们旨在评估人口统计学、临床和尿动力学变量与 rUTI 之间的关联。
回顾性分析了 136 名接受清洁间歇性导尿（CIC）的 SCI 患者的记录。所有患者均进行了视频尿动力学研究（VUDS）分析。将患者分为非复发性（<3/年）或 rUTI（≥3/年）组。分析两组间的差异。采用多变量逻辑回归确定各种人口统计学、临床和 VUDS 变量与 rUTI 之间的关联。
136 名患者中有 58 名自述 rUTI。在有尿培养结果的 124 名患者中，非裔美国人（43.3% vs. 22.3%）和“其他”种族（13.3% vs. 8.5%）在 rUTI 组中所占比例较大。女性（OR 4.96，95%CI [1.44-17.13]）和非裔美国人（OR 5.16，95%CI [1.80-14.79]）种族在多变量逻辑回归中与 rUTI 呈正相关。受伤后时间间隔越短，感染复发的可能性越低（OR 0.91，95%CI [0.82-0.99]）。两组间 VUDS 变量无显著差异，且回归分析无变量为 rUTI 的潜在决定因素。
在接受 CIC 的 SCI 患者中，患者种族、性别和 SCI 后时间似乎与 rUTI 有显著关联。然而，VUDS 变量与 rUTI 无显著相关性。
