title: Morbidity of urinary tract infection after urodynamic examination of hospitalized SCI patients: the impact of bladder management.
abstract: METHODS
  Non-interventional, descriptive-observational cohorts study.
  
  
  OBJECTIVE
  To assess the incidence of urinary tract infection (UTI) after urodynamic examination in patients with spinal cord injury (SCI) according to bladder management.
  
  
  METHODS
  Level 1 trauma center.
  
  
  METHODS
  Between January and December 2010 a total of 133 consecutive, hospitalized SCI patients were included and classified according to their bladder management. Urine specimen was obtained at the beginning of the urodynamic studies (UDS) and 3-5 days thereafter. 'Significant bacteriuria' (SBU) is defined by a CBU per ml level ≥10(5) in a urine culture. UTI thus is defined as a combination of a SBU and ≥100 leukocytes per μl in urine analysis.
  
  
  RESULTS
  The overall incidence of UTI post UDS was 15.79%. In patients with sterile urine prior to urodynamics UTI was ascertained in 8.6% (de-novo-UTI). In contrast, 32.5% of the patients with SBU prior to UDS showed UTI 3 days later. There were only minor differences in the incidence of de-novo-UTIs in SCI patients who emptied their bladder by intermittent self catheterization or intermittent catheterization by attendant (8.82% and 6.67%, respectively). In SCI patients with reflex voiding however, the frequency of de-novo-UTIs was twice as high (14.28%).
  
  
  CONCLUSIONS
  The recommendation of antibiotic prophylaxis for all SCI patients undergoing urodynamic examination is not commonly accepted and according to our data not justified. However, the analysis of subgroups revealed that SCI patients with unsuspected SBU prior to UDS and patients with reflex voiding are possibly at higher risk to acquire post-UDS infection.
authors.affiliation: Department Neuro-Urology, BG Trauma Hospital Hamburg, Hamburg, Germany. r.boethig@buk-hamburg.de
authors.forename: R
authors.initials: R
authors.lastname: Böthig
authors.forename: K
authors.initials: K
authors.lastname: Fiebag
authors.forename: R
authors.initials: R
authors.lastname: Thietje
authors.forename: M
authors.initials: M
authors.lastname: Faschingbauer
authors.forename: S
authors.initials: S
authors.lastname: Hirschfeld
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000453:epidemiology / Q000209:etiology; D019090:Case Management; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012018:Reflex / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D014554:Urination / Q000502:physiology; D014563:Urodynamics / Q000502:physiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents