Abstract

HERNANDEZ GONZALEZ, E. et al. Epidemiologic, clinical and microbiological characteristics of nosocomial urinary infection in the spinal cord lesioned patient. Actas Urol Esp [online]. 2007, vol.31, n.7, pp.764-770. ISSN 0210-4806.

Urinary infections constitute one of the main causes of intrahospitalary infections. At the Clinic for the attention of spinal cord injured (SCI) patients, we observed that these can be the causes of high incidence rates as a consequence of multiple risk factors associated with the neurogenic bladder as: vesical urethral reflux, vesicle lithiasis, diverticula and pseudodiverticula, urethral stenosis and permanent or intermittent catheterization. Objectives: To describe forms of presentation of urinary tract infections (UTI) in spinal cord lesioned patients with neurogenic bladder as well as their microbiological behavior. Patients and Method: We performed a descriptive, retrospective-type study on 28 patients in order to schedule a neurorestorative treatment for the affectation of the SCI for six months. They all received clinical, imaging test and bacteriologic assessment, that is, urocultures, uretheral and vaginal exudates to determine risk factors, forms of presentation of the infection, as well as associated complications and microbiological behavior. Results: The most frequent forms of presentation of infections are: recurrent symptomatic bacteriuria, asymptomatic bacteriuria, bacterial urethritis, bacterial vaginosis and acute pyelonephrites. Most acute germs are: E coli (for a 60% of isolation), followed by P. mirabilis (14%), K pneumoniae (l0%), Staphylococcus sp. (4%), and other enterobacteria. Sensitiveness to aminoglycosides was kept high, where we observed a growing resistance to sulphas (>70%) and fluoroquinolones (>45%) as well as the frequent circulation of multirresistant microorganisms. Conclusions: Clinical peculiarities of urinary infections in the patient with neurogenic bladder, allow to perform more adequate strategies for treatment as to the clinical, microbiological and epidemiologic criteria.

Keywords : Urinary tract infections; Spinal cord injures; E. coli; Neurogenic bladder.

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