title: Retrospective study for risk factors for febrile UTI in spinal cord injury patients with routine concomitant intermittent catheterization in outpatient settings.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  The objective of this study was to investigate the clinical risk factors for febrile urinary tract infection (UTI) in spinal cord injury-associated neurogenic bladder (NB) patients who perform routine clean intermittent catheterization (CIC).
  
  
  METHODS
  Rehabilitation Hospital, Kobe, Japan.
  
  
  METHODS
  Over a 3-year period, we retrospectively assessed the clinical risk factors for febrile UTI in 259 spinal cord injury patients diagnosed as NB and performing routine CIC with regard to the factors such as gender, the presence of pyuria and bacteriuria, and the categories of the American Spinal Injury Association (ASIA) impairment scale.
  
  
  RESULTS
  A total of 67 patients had febrile UTI in the follow-up period, with 57 cases of pyelonephritis, 11 cases of epididymitis and 2 cases of prostatitis, including the patients with plural infectious diseases. The causative bacteria were ranked as follows: Escherichia coli (74 cases), Pseudomonas aeruginosa (17 cases), Enterococcus faecalis (14 cases) and Klebsiella pneumoniae (12 cases). Antibiotic-resistant E. coli were seen, with 10.5% instances of extended-spectrum β-lactamase (ESBL) production and 23.8% of fluoroquinolone resistance. Multivariate analyses of clinical risk factors for febrile UTI showed that gender (male, P=0.0431), and ASIA impairment scale C or more severe (P=0.0266) were significantly associated with febrile UTI occurrence in NB patients with routine CIC.
  
  
  CONCLUSIONS
  Our data demonstrated gender (male) and ASIA impairment scale C or more severe were significantly associated with febrile UTI occurrence in NB patients using routine CIC. Further prospective studies are necessary to define the full spectrum of possible risk factors for febrile UTI in these patients.
authors.affiliation: Department of Infection Control and Prevention, Hyogo Prefectural Rehabilitation Center, Kobe, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Mukai
authors.affiliation: Department of Surgery, Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.|Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shigemura
authors.affiliation: Department of Infection Control and Prevention, Hyogo Prefectural Rehabilitation Center, Kobe, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nomi
authors.affiliation: Department of Infection Control and Prevention, Hyogo Prefectural Rehabilitation Center, Kobe, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Sengoku
authors.affiliation: Department of Surgery, Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Yamamichi
authors.affiliation: Department of Surgery, Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Department of Surgery, Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.|Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Arakawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010045:Outpatients; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000453:epidemiology / Q000209:etiology*; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents