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Occurrence of Urinary Tract Infection in Reference to Bladder-emptying Method and Etiological Agents among Spinal Cord Injury Patients: A Cross-sectional Study

Spinal cord injury (SCI) patients who develop neurogenic bladder can not have normal physiological voiding and require catheterization for bladder drainage. The method of bladder drainage influences risk of urinary tract infection (UTI) and most people on the indwelling catheter or intermittent catheterization develop urinary tract infection. A cross-sectional study among 138 SCI patients admitted in the Department of Physical Medicine and Rehabilitation, Sawai Man Singh Medical College, and Jaipur was done. Urine samples were sent to Microbiology department for culture and antibiotic sensitivity test. Bacteria found resistant to three or more of the envisaged antibiotics were considered multidrug-resistant. The study revealed that 87.68% patients had significant bacteriuria. Asymptomatic and symptomatic UTI developed in 65.94% and 21.74% respectively. Symptomatic UTI was significantly associated with indwelling catheter user (p value < 0.05). The most common organism isolated was E. coli (49.30%) followed by Enterobacter aerogenes (14%). About 50.70% isolated organisms were multidrug-resistant and 4.22% organisms were extensively drug resistant. Development of multidrug-resistant organism was highest who were using an indwelling catheter (p value < 0.05). Clean intermittent catheterization (CIC) should be preferred the option to manage the neurogenic bladder in spinal cord injury patients. Not urine culture with significant bacteriuria but symptomatic UTI should be treated.