title: Risk Factors Associated With Recurrent Urinary Tract Infection in Neurogenic Bladders Managed by Clean Intermittent Catheterization.
abstract: OBJECTIVE
  To identify risk factors for recurrent urinary tract infection (UTI) in patients who perform clean intermittent catheterization (CIC).
  
  
  METHODS
  A 6-year retrospective chart review of patients with spina bifida or tethered cord who perform clean intermittent catheterization (8 months to 58 years) was conducted. A strict case definition for UTI was applied, and per-subject UTI events, demographic, and clinical data were abstracted. Data were compared between groups defined by no or infrequent UTI (≤1.0 UTI/study year) and frequent UTI (>1.0 UTI/study year).
  
  
  RESULTS
  Of 194 total patients, 146 (75%) had no UTIs or infrequent UTIs, and 48 (25%) patients had frequent UTIs. On univariate analysis, only younger age and suprasacral cord lesions were associated with frequent UTIs (P = .002 and P = .007, respectively). Among the 128 patients with urodynamic studies, bladder capacity, compliance, detrusor overactivity, and detrusor leak point pressure were not associated with frequent UTI on univariate analysis. On multivariate analysis, increasing age was found to be associated with decreased odds of UTI by 7% per year (odds ratio 0.93, P = .016).
  
  
  CONCLUSIONS
  The risk of UTI among individuals with spina bifida or tethered cord declines with increasing age. Bladder function based on urodynamic parameters did not correlate with frequent UTIs.
authors.affiliation: Department of Surgery, Division of Urologic Surgery, Duke University, Durham, NC.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Chaudhry
authors.affiliation: Department of Surgery, Division of Urologic Surgery, Duke University, Durham, NC.
authors.forename: Zarine R
authors.initials: ZR
authors.lastname: Balsara
authors.affiliation: Department of Surgery, Division of Urologic Surgery, Duke University, Durham, NC.
authors.forename: Ramiro J
authors.initials: RJ
authors.lastname: Madden-Fuentes
authors.affiliation: Department of Surgery, Division of Urologic Surgery, Duke University, Durham, NC.
authors.forename: John S
authors.initials: JS
authors.lastname: Wiener
authors.affiliation: Department of Surgery, Division of Urologic Surgery, Duke University, Durham, NC.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Routh
authors.affiliation: Department of Pediatrics, Division of Infectious Disease, Duke University, Durham, NC.
authors.forename: Patrick
authors.initials: P
authors.lastname: Seed
authors.affiliation: Department of Urology, Section of Pediatric Urology, School of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. Electronic address: Sherry_Ross@med.unc.edu.
authors.forename: Sherry S
authors.initials: SS
authors.lastname: Ross
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D057928:Intermittent Urethral Catheterization / Q000009:adverse effects / Q000379:methods; D008297:Male; D009436:Neural Tube Defects / Q000150:complications*; D010043:Outcome and Process Assessment, Health Care; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016135:Spinal Dysraphism / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000209:etiology; D014563:Urodynamics