Microbial etiology of UTI in an SCI cohort

Evans CT, Joseph G, Weaver FM. Microbial etiology of UTI in an SCI cohort. Paper presented at: American Spinal Injury Association Annual Meeting; 2003 Apr 1; Miami, FL.

Objective: To assess the microbial etiology of urinary tract infections in veterans with spinal cord injury (SCI) admitted to an SCI unit.Design: Retrospective review of patients with UTI and urine cultures conducted between October 1, 1998-September 30, 2000.Participants/Methods: The VA National Patient Care Database was used to identify patients with a UTI using ICD9 codes. Urine culture data was obtained from the Centers' local clinical database to identify UTI causing organisms. All urine cultures conducted from the admission date until the time of discharge were included. Results: 171 patients had one or more UTI diagnoses over two years, comprising 273 UTI admissions (X = 1.6 admissions/patient). 163 (95.3%) of these patients and 252 (92.3%) admissions had urine cultures. Most UTI admissions were for a secondary diagnosis of UTI (65.1%). A total of 630 urine cultures were conducted across all admissions (X = 2.5 cultures/admission), where 60.3% cultures occurred during admissions where UTI was the secondary diagnosis. This resulted in an average of 2.8 cultures per primary admission and 2.3 cultures per secondary admission (p = 0.2257). 1,122 organisms were isolated from these cultures. The most common organisms identified were gram negative rods (14.5%), Enterococcus species (13.0%), gram positive cocci (unspecified) (13.0%), Pseudomonas aeruginosa (12.0%), Staphylococcus species (7.3%), Citrobacter species (6.7%), and Escherichia coli (6.2%). Conclusions: A variety of organisms were found that appear to be consistent with the etiology of infection in SCI. Further analysis will assess whether there are differences in patient characteristics by type of organism, number of organisms found in each culture, and antibiotic resistance.