FREQUENCY OF URINARY TRACT INFECTION (UTI) & COMMONEST CAUSATIVE ORGANISMS IN SPINAL CORD INJURY PATIENTS WITH VARIOUS VOIDING

Abstract

Objective of study: To determine the frequency of urinary tract infection and commonest causative organisms in spinal cord injury patients with various modes of voiding in rehabilitation setup in Pakistan.
Design: A descriptive study of 100 spinal cord injury patients.
Setting: This study was carried out in Armed Forces Institute of Rehabilitation medicine (AFIRM) Rawalpindi from 15 September 2007 to 15 March 2008 on clinical samples received from admitted patients in CMH Rawalpindi and AFIRM.
Material and Methods: In 100 patients of spinal cord injury after history and detailed physical examination blood samples were collected for (TLC) Total Leucocytes Count and urine samples were subjected to Urine RE and Urine C/S. Urine culture revealing a bacterial colony count of 105 cfu/ml or higher were considered positive for urinary tract infection (UTI) if present with symptoms. Significant bacteriuria was investigated for spectrum and sensitivity pattern as well.
Results: Of all 100 spinal cord patients 52 patients (52%) had symptoms suggestive of UTI but only 37 patients (37%) had significant bacteriuria on urine culture supported by high level pyuria were declared to have UTI. E-coli was the most commonly isolated organism with total no of 20 cases (54.1%) followed by Pseudomonas total no of 6 cases (16.2%), Klebsiella pneumoniae with total no of 3 cases (8.1%), Proteus mirabilis with total no of 3 cases (8.1%), Citrobacter freundi with total no of 2 cases (5.4%) and the least frequent was Morganella morganii with 1 case (2.7%).UTI was most frequent in patients with Indwelling catheter and was least associated with self voiding.
Conclusion: Urinary Tract Infection was commonly observed among spinal cord injury patients. E-coli was the commonest isolated pathogen followed by Pseudomonas, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter freundi, Candida and Morganella morganii in descending order of frequency. UTI was most frequent in patients using Indwelling catheter as a mode of voiding.