Current implications of drug resistance in spinal cord injury.
A 54-yr-old man with C6 quadriplegia and a neurogenic bowel and bladder was evaluated for clearance of a urinary tract infection after treatment for organisms susceptible to the antibiotics used, and an organism resistant to all antibiotics on the panel grew on the initial follow-up urine culture. Multidrug-resistant organisms present increasing challenges and risks in the management of the neurogenic bladder in patients with spinal cord injury. In an effort to control and reduce the impact and risk associated with these organisms, management methods of the neurogenic bladder and infection control policies should be adjusted according to guidelines from the Centers for Disease Control and related research; such policies could include surveillance for multidrug-resistant organisms and isolation of patients who test positive for these organisms.
Murphy
Douglas P
DP
Department of Physical Medicine and Rehabilitation, Woodrow Wilson Rehabilitation Center, Fisherville, Virginia 22939, USA.
Lampert
Vickie
V
D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control; D016971:Citrobacter freundii; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D004756:Enterobacteriaceae Infections / Q000209:etiology; D013293:Enterococcus faecalis; D016908:Gram-Positive Bacterial Infections / Q000209:etiology; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards; D007710:Klebsiella Infections / Q000209:etiology; D007711:Klebsiella pneumoniae; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications*; D013203:Staphylococcal Infections / Q000209:etiology; D013211:Staphylococcus aureus; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D014552:Urinary Tract Infections / Q000209:etiology* / Q000517:prevention & control; D020713:Vancomycin Resistance