Microbiology of the urethra and perineum and its relationship to bacteriuria in community-residing men with spinal cord injury.
OBJECTIVE
Reasons why some persons with spinal cord injury (SCI) experience recurrent urinary tract infections more than others are poorly understood. We performed a prospective study of bacterial flora of the urethra and perineum in men with and without bacteriuria to understand more completely the relationship between bacterial colonization and invasion of the urinary tract.


METHODS
Urine, urethra, and perineum cultures were obtained from 70 men. Microbial flora of these sites was compared for men with and without bacteriuria.


RESULTS
Urine colony count was 0 in 16 (22.9%) men. Perinea in 2 men (12.5%) and urethras in 6 men (37.5%) were colonized with various gram-negative bacilli, enterococci, and/or Staphylococcus aureus. Among 54 (77.1%) men with bacteriuria, uropathogens were shown in the perineum in 31 (57.4%) and in the urethra in 46 (85.2%). In 40 (74.1%) of men with bacteriuria, at least one bacterial species present in the urine was also found in the urethra and/or perineum. Differences in the occurrence of uropathogens in men with and without bacteriuria were statistically significant, and organisms were present in higher numbers in men with bacteriuria.


CONCLUSIONS
Men with SCI who have bacteriuria are significantly more likely to be colonized in the distal urethra and perineum with uropathogens that are often present in the urine in comparison with men without bacteriuria.
Waites
Ken B
KB
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA. waites@path.uab.edu
Canupp
Kay C
KC
DeVivo
Michael J
MJ
D000328:Adult; D000368:Aged; D001437:Bacteriuria / Q000382:microbiology*; D015169:Colony Count, Microbial; D017714:Community-Acquired Infections / Q000382:microbiology*; D016983:Enterococcus / Q000302:isolation & purification; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000382:microbiology; D010502:Perineum / Q000382:microbiology*; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014521:Urethra / Q000382:microbiology*; D001750:Urinary Bladder, Neurogenic / Q000382:microbiology; D014546:Urinary Catheterization / Q000379:methods; D014552:Urinary Tract Infections / Q000382:microbiology