nach oben

World Journal of Urology

Erschienen in:

04.04.2019 | Original Article

Risk factors for febrile genito-urinary infection in the catheterized patients by with spinal cord injury-associated chronic neurogenic lower urinary tract dysfunction evaluated by urodynamic study and cystography: a retrospective study

verfasst von: Katsumi Shigemura, Koichi Kitagawa, Masashi Nomi, Akihiro Yanagiuchi, Atsushi Sengoku, Masato Fujisawa

Erschienen in: World Journal of Urology | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Introduction

To investigate the risk factors for febrile genito-urinary tract infection (GUTI) in spinal cord injury-associated neurogenic lower urinary tract dysfunction (NLUTD) patients who perform routine clean intermittent catheterization (CIC) evaluated by urodynamic study (UDS) and cystography.

Patients and methods

Over a 3-year period, we retrospectively assessed risk factors for febrile UTI in 141 spinal cord injury patients diagnosed as NLUTD and performing routine CIC, regarding gender, UDS findings such as bladder compliance, maximum cystometric capacity, and cystography.

Results

A total of 41 patients had febrile GUTI in the follow-up period as along with 32 cases of pyelonephritis, 10 cases of epididymitis, and 1 case of prostatitis, including patients with multiple infectious diseases. The causative bacteria were Escherichia coli (14 cases) followed by Pseudomonas aeruginosa (n = 5), Klebsiella pneumoniae (n = 4), and Klebsiella oxytoca (n = 4). Antibiotic-resistant E. coli were seen, with 36.4% instances of extended-spectrum beta-lactamase production in whole of E. coli. Male gender (p = 0.018), ASIA Impairment Scale (AIS) C or more severe (p = 0.031), the number of CIC (p = 0.034), use of quinolones (p < 0.001) and severe bladder deformity (DG 2 or more, p = 0.004) were significantly associated with febrile GUTI occurrence.

Conclusions

Our data demonstrated that male gender, severe bladder deformity (DG 2 or more), AIS C or more, the number of CIC, and use of quinolones were significantly associated with febrile GUTI occurrence in NLUTD patients employing routine CIC. Further prospective studies are necessary to define the full spectrum of possible risk factors for febrile GUTI in these patients.

Burns AS, Rivas DA, Ditunno JF (2001) The management of neurogenic bladder and sexual dysfunction after spinal cord injury. Spine 26(24(Suppl)):S129–S136CrossRef

Ogawa T (1991) Bladder deformities in patients with neurogenic bladder dysfunction. Urol Int 47(Suppl 1):59–62CrossRef

Mukai S, Shigemura K, Nomi M, Sengoku A, Yamamichi F, Fujisawa M et al (2016) Retrospective study for risk factors for febrile UTI in spinal cord injury patients with routine concomitant intermittent catheterization in outpatient settings. Spinal Cord 54:69–72CrossRef

Yamanishi T, Sakakibara R, Uchiyama T, Hirata K (2011) Role of urodynamic studies in the diagnosis and treatment of lower urinary tract symptoms. Urol Sci 22:120–128CrossRef

Kakizaki H, Igawa Y, Gotou M et al (2005) Clinical practice guideline for lower urinary tract dysfunction in patients with chronic spinal cord injury. Japan Medical Society of Spinal Cord Lesion, pp 58–63

Chaudhry R, Balsara ZR, Madden-Fuentes RJ, Wiener JS, Routh JC, Seed P et al (2017) Risk factors associated with recurrent urinary tract infection in neurogenic bladders managed by clean intermittent catheterization. Urology 102:213–218CrossRef

Consortium for Spinal Cord Medicine (2006) Bladder management for adults with spinal cord injury: a clinical practice guideline for health-care providers. J Spinal Cord Med 29:527–573

Gajewski JB, Schurch B, Hamid R, Averbeck M, Sakakibara R, Agrò EF, Dickinson T, Payne CK, Drake MJ, Haylen B (2018) An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD). Neurourol Urodyn 37:1152–1161CrossRef

Schuld C, Franz S, Brüggemann K, Heutehaus L, Weidner N, Kirshblum SC, Rupp R, EMSCI study group, (2016) International standards for neurological classification of spinal cord injury: impact of the revised worksheet (revision 02/13) on classification performance. J Spinal Cord Med 39:504–512CrossRef

10.

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178CrossRef

11.

JAID/JSC Guide/Guidelines to Clinical Management of Infectious Diseases (2017) JAID/JSC guidelines for clinical management of infectious disease 2015—urinary tract infection/male genital infection. J Infect Chemother 23:733–751CrossRef

12.

Najar MS, Saldanha CL, Banday KA (2009) Approach to urinary tract infections. Indian J Nephrol 19:129–139CrossRef

13.

Beraldo PS, Neves EG, Alves CM, Khan P, Cirilo AC, Alencar MR (1993) Pyrexia in hospitalised spinal cord injury patients. Paraplegia 31:186–191PubMed

14.

Schaeflfer AJ, Schaeffer EM (2011) Infections of the urinary tract. In: Wein AJ, Kavoussi LR, Novick AC et al (eds) Campbell-Walsh Urology, 10th edn. Elsevier-Saunders, Philadelphia, pp 257–326

15.

Clinical and Laboratory Standards Institute (2009) Performance standards for antimicrobials susceptibility testing; nineteenth informational supplement 2009. M100-S19. Clinical and Laboratory Standards Institute, Wayne, Philadelphia

16.

Salameh A, Al Mohajer M, Daroucihe RO (2015) Prevention of urinary tract infections in patients with spinal cord injury. CMAJ 187:807–811CrossRef

17.

Moro-Garcia MA, Alonso-Arias R, Lopez-Vazquez A, Suárez-García FM, Solano-Jaurrieta JJ, Baltar J, López-Larrea C (2012) Relationship between functional ability in older people, immune system status, and intensity of response to CMV. Age (Dordr) 34:479–495CrossRef

18.

Mody L, Greene MT, Meddings J, Krein SL, McNamara SE, Trautner BW, Ratz D, Stone ND, Min L, Schweon SJ, Rolle AJ, Olmsted RN, Burwen DR, Battles J, Edson B, Saint S (2017) A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents. JAMA Intern Med 177:1154–1162CrossRef

19.

Stauffer CE, Snyder E, Ngo TC, Elliott CS (2018) Is neurogenic bladder a risk factor for febrile urinary tract infection after ureteoscopy and if so, why? Urology 112:33–37CrossRef

20.

Wang QW, Song DK, Zhang XP, Wu YD, Zhang RL, Wei JX et al (2011) Urodynamic parameters development and complications of clean intermittent self-catheterization in Chinese school children with neurogenic underactive bladder. Urol Int 86:461–465CrossRef

21.

Krebs J, Wöllner J, Pannek J (2016) Risk factors for symptomatic urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord 54:682–686CrossRef

22.

Maurya VP, Rajappa M, Wadwekar V, Narayan SK, Barathi D, Madhugiri VS (2016) Tethered cord syndrome—a study of the short-term effects of surgical detethering on markers of neuronal injury and electrophysiologic parameters. World Neurosurg 94:239–247CrossRef

23.

Kitagawa K, Shigemura K, Yamamichi F, Alimsardjono L, Rahardjo D, Kuntaman K et al (2018) International comparison of causative bacteria and antimicrobial susceptibilities of urinary tract infections between Kobe, Japan, and Surabaya, Indonesia. Jpn J Infect Dis 71:8–13CrossRef

Titel: Risk factors for febrile genito-urinary infection in the catheterized patients by with spinal cord injury-associated chronic neurogenic lower urinary tract dysfunction evaluated by urodynamic study and cystography: a retrospective study
verfasst von: Katsumi Shigemura
Koichi Kitagawa
Masashi Nomi
Akihiro Yanagiuchi
Atsushi Sengoku
Masato Fujisawa
Publikationsdatum: 04.04.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 3/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02743-5

Neu im Fachgebiet Urologie

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

16.05.2024 alpha-1-Rezeptorantagonisten Nachrichten

Nach einer Prostatabiopsie treten häufig Probleme beim Wasserlassen auf. Ob sich das durch den periinterventionellen Einsatz von Alphablockern verhindern lässt, haben australische Mediziner im Zuge einer Metaanalyse untersucht.

S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Risk factors for febrile genito-urinary infection in the catheterized patients by with spinal cord injury-associated chronic neurogenic lower urinary tract dysfunction evaluated by urodynamic study and cystography: a retrospective study