title: Uropathogens and empiric antibiotics for the treatment of urinary tract infections in spinal cord injured patients at rehabilitation center, Thai Red Cross Society during 2001 to 2005.
abstract: BACKGROUND
  Urinary tract infection (UTI) is common in spinal cord injured patients. The authors investigated the epidemiology of bacteria associated with UTI to select an appropriate antibiotic for empirical treatment of UTI before obtaining a bacterial culture.
  
  
  OBJECTIVE
  To determine the prevalence, as well as the causative bacteria and their susceptibility pattern of urinary tract infection in spinal cord injured patients hospitalized to the Rehabilitation Center, Thai Red Cross Society, Samutprakarn, Thailand from January 2001 to December 2005.
  
  
  METHODS
  A retrospective chart review of 76 spinal cord injured patients.
  
  
  RESULTS
  Of all spinal cord injured patients, there were 50 males and 26 females, with the average age of 44.70 years. The average length of hospitalization was 104.5 days. 71.2% of the patients needed intermittent catheterization for bladder drainage, and only 2.7% had suprapubic cystostomy. None of patient had indwelling catheterization. Forty-six patients had 68 episodes of UTI (60.52%). Eighteen patients had recurrent UTI (14 patients had two episodes and four patients had three episodes). E. coli was the most common isolated pathogen (74.36%) followed by K. pneumoniae (12.82%), E. faecalis (5%) and P. mirabilis (5%). Most gram-negative pathogens were susceptible to amikacin and third generation cephalosporins. The susceptibility of these organisms to cotrimoxazole, amoxicillin/clavulanate, and ciprofloxacin were in the range of 34.6-60.0%, 44.0-50.0% and 25.9-50.0%, respectively.
  
  
  CONCLUSIONS
  Urinary tract infections were commonly observed among spinal cord injured patients in the presented institution. E. coli was the most common isolated pathogen. Surprisingly, most gram-negative pathogens were resistant to cotrimoxazole, amoxicillin/clavulanate, and ciprofloxacin. An antibiotic of choice for UTI in our patients should be aminoglycoside or third generation cephalosporins.
authors.affiliation: Rehabilitation Center, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Natthiya
authors.initials: N
authors.lastname: Tantisiriwat
authors.forename: Wasuwat
authors.initials: W
authors.lastname: Kittisomprayoonkul
authors.forename: Kwanyupa
authors.initials: K
authors.lastname: Sukonthamarn
authors.forename: Chudaachhara
authors.initials: C
authors.lastname: Unhasuta
authors.forename: Chusana
authors.initials: C
authors.lastname: Suankratay
authors.forename: Woraphot
authors.initials: W
authors.lastname: Tantisiriwat
authors.forename: Sek
authors.initials: S
authors.lastname: Aksaranugraha
mesh_terms: D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000188:drug therapy*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007902:Length of Stay; D008297:Male; D015995:Prevalence; D012011:Red Cross; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D012955:Societies, Medical; D013119:Spinal Cord Injuries / Q000150:complications*; D013785:Thailand; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000583:Amikacin