Pathogen distribution in a rehabilitation medicine department and the risk analysis of urinary tract infection for spinal cord injury patients based on urodynamic results
10.3760/cma.j.cn421666-20230420-00324
- VernacularTitle:康复医学科脊髓损伤患者尿路感染的病原菌分布及其危险因素分析
- Author:
Si TIAN
1
;
Qin CHEN
1
;
Dawei CHEN
1
;
Dingqun BAI
1
;
Haidan LIN
1
Author Information
1. 重庆医科大学附属第一医院康复医学科，重庆 400016
- Publication Type:Journal Article
- Keywords:
Spinal cord injury;
Urinary tract infection;
Neurogenic bladder;
Urodynamics
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(2):138-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the distribution of pathogens and the risk of urinary tract infection for hospitalized spinal cord injury (SCI) patients.Methods:A total of 152 hospitalized SCI patients with a urinary tract infection were randomly divided into a complicated infection group (77 cases) and an uncomplicated infection group (75 cases) according to the diagnostic criteria for urinary tract infection. Univariate analysis quantified any correlation of urinary tract infection with gender, age, etiology, course of disease, injury level, injury degree, indwelling catheter use, diabetes history, hypoproteinemia, pressure ulcers, bladder compliance, maximum bladder manometric volume, maximum detrusor pressure during urine storage and detrusor overactivity during urine storage. Multivariate logistic regressions were evaluated to determine the independent risk factors.Results:A total of 124 pathogens were found in the subjects′ urine cultures. They included 83 gram-negative (G-) bacteria (66.94%), 31 gram-positive (G+ ) bacteria (25.00%), 9 fungi (7.26%) and 1 mycoplasm. The most common G- pathogen was Escherichia coli (42, 50.60%) with Enterococcus faecium (6, 19.35%) the most common G+. Overall, the five most common pathogens were Escherichia coli (42 strains, 33.87%), Klebsiella pneumoniae (10 strains, 8.06%), Proteus mirabilis (8 strains, 6.45%), Acinetobacter baumannii (7 strains, 5.65%), and Enterococcus faecium (6 strains, 4.84%). The univariate analysis showed that the etiology, injury level, injury degree, an indwelling catheter, pressure ulcers, maximum cystometric capacity, maximum detrusor pressure and detrusor overactivity in the storage phase were predictors of infection. The multivariate logistic regression analysis revealed that complete injury, an indwelling catheter, and increased maximum detrusor pressure in the storage phase were the independent risk factors.Conclusions:Escherichia coli is the most common pathogen causing urinary tract infection among SCI patients undergoing rehabilitation during hospitalization. Complete injury, an indwelling catheter, and increased maximum detrusor pressure in storage phase may be independent risk factors for urinary tract infection among such patients.
