Causative Organisms and Antimicrobial Susceptibility of Urinary Tract Infection of Spinal Cord Injured Patients

Jeong, Ho Joong; Choi, Sung Bock

Abstract

BACKGROUND: To provide useful information on the choice of adequate drugs in the treatment of urinary tract infection (UTI) in spinal cord injury patients.
MATERIALS AND METHODS
The subjects were 34 spinal cord injured patients who were registered in Busan Spinal Cord Disabled Person Society and 111 patients with spinal cord injury who were admitted in 4 university hospitals in Busan between January 2004 and December 2005. We collected the patient's urine in July 2006 and performed comprehensive chart reviews of these patients. We studied the incidence of UTI, commonly cultured organisms, antimicrobial sensitivities, voiding methods and follow-up.
RESULTS
The incidence of UTI was 48.3% of 145 patients. The most common causative organism of UTI was Escherichia coli (27.1%), followed by Pseudomonas aeruginosa (22.9%) and Klebsiella pneumoniae (8.3%). Antimicrobial sensitivities of imipenem, amikacin and ceftazidime to Escherichia coli were respectively 100%, 92.3%, 80.8%. The sensitivities of Pseudomonas to the same agents were 63.6%, 31.8 %, 45.5% respectively. Ciprofloxacin showed decreased sensitivities of 38.5%, 31.8% respectively for Escherichia coli and Pseudomonas aeruginosa.
CONCLUSION
Our results implied decreasing susceptibility of ciprofloxacin, so it can be recommended to restrict the use of ciprofloxacin as a primary empirical antibiotic for UTI of spinal cord injured patients. Causative organisms of UTI are becoming more diverse. Also the incidence and antimicrobial sensitivities are changing as well. Therefore continuous observation with the appropriate treatment is needed.