Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
DOI: | 10.25759/spmfr.262 |
Texto Completo: | https://doi.org/10.25759/spmfr.262 |
Resumo: | Introduction: Our objective was the identification and characterization of the bacterial spectrum and of its susceptibility to antibiotics in patients treated in a Spinal Cord Injury Unit. The determination of the role played in the infections by the vesical emptying method and the medullar injury, as classified by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI).Material and Methods: We retrospectively analyzed 79 patients who had been hospitalized in a Spinal Cord Injury Unit between 1/09/2014 and 1/09/2015. One hundred and fifty-eight urine samples were collected and sent for bacteriological examination. The urine samples were collected only in cases where there was clinical suspicion of a UTI. The variables taken into account were: gender, age, ISCNCSCI classification, antibiotic therapy applied, microorganisms isolated in the urine cultures, the method employed to bladder emptying at the time of the infection, and the profile of resistance to antibiotics.Results: We found that 75.9% of patients contracted at least one UTI in our Spinal Cord Injury Unit, with a higher frequency detected among those subjected to a urinary catheterization technique. Patients undergoing continuous catheterization presented a higher number of UTIs than those on intermittent catheterization. The most common bacteria isolated were Klebsiella pneumoniae (43%) and Escherichia coli (22.8%). We determined that 71.5% of the isolated bacteria were multidrug-resistant. The highest rates of resistance (82%) were found among patients undergoing continuous catheterization (p < 0.05).Conclusion: Klebsiella pneumoniae was the most frequent bacterial cause of UTIs in our unit. Our results are consistent with scientific reports describing increasingly higher levels of bacterial resistance to drugs, as well as a higher rate of multi-resistant infections within the population with SCI. Intermittent catheterization is preferable, since most UTIs were reported among patients undergoing continuous catheterization. AIS D patients, and those with spontaneous urination, exhibited a lower rate of infection. These results are food for thought on the antimicrobial resistance of bacteria and on the need for the development of alternative strategies to prevent UTIs. |
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Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation UnitAvaliação das Infecções do Trato Urinário e a Resistência Antimicrobiana numa Unidade de Reabilitação de Lesionados MedularesDrug Resistance, Multiple, Bacterial; Spinal Cord Injuries/complications; Urinary Tract InfectionsFarmacorresistência Bacteriana Múltipla; Infecções Urinárias; Lesões Medulares/complicaçõesIntroduction: Our objective was the identification and characterization of the bacterial spectrum and of its susceptibility to antibiotics in patients treated in a Spinal Cord Injury Unit. The determination of the role played in the infections by the vesical emptying method and the medullar injury, as classified by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI).Material and Methods: We retrospectively analyzed 79 patients who had been hospitalized in a Spinal Cord Injury Unit between 1/09/2014 and 1/09/2015. One hundred and fifty-eight urine samples were collected and sent for bacteriological examination. The urine samples were collected only in cases where there was clinical suspicion of a UTI. The variables taken into account were: gender, age, ISCNCSCI classification, antibiotic therapy applied, microorganisms isolated in the urine cultures, the method employed to bladder emptying at the time of the infection, and the profile of resistance to antibiotics.Results: We found that 75.9% of patients contracted at least one UTI in our Spinal Cord Injury Unit, with a higher frequency detected among those subjected to a urinary catheterization technique. Patients undergoing continuous catheterization presented a higher number of UTIs than those on intermittent catheterization. The most common bacteria isolated were Klebsiella pneumoniae (43%) and Escherichia coli (22.8%). We determined that 71.5% of the isolated bacteria were multidrug-resistant. The highest rates of resistance (82%) were found among patients undergoing continuous catheterization (p < 0.05).Conclusion: Klebsiella pneumoniae was the most frequent bacterial cause of UTIs in our unit. Our results are consistent with scientific reports describing increasingly higher levels of bacterial resistance to drugs, as well as a higher rate of multi-resistant infections within the population with SCI. Intermittent catheterization is preferable, since most UTIs were reported among patients undergoing continuous catheterization. AIS D patients, and those with spontaneous urination, exhibited a lower rate of infection. These results are food for thought on the antimicrobial resistance of bacteria and on the need for the development of alternative strategies to prevent UTIs.Introdução: O objetivo do estudo foi identificar e caracterizar o espetro bacteriano e a sua suscetibilidade a antibióticos na urina de doentes com bexiga neurogénica hospitalizados numa Unidade de Reabilitação de Lesionados Medulares . Determinar a presença de infeção segundo o regime vesical e a lesão medular enquadrada na classificação “International Standards for Neurological Classification of Spinal Cord Injury” (ISNCSCI).Material e Métodos: Analisaram-se retrospetivamente 79 pacientes hospitalizados numa Unidade de Lesionados Medulares entre 1/09/2014 e 1/09/2015. Foram realizadas 158 colheitas de urina e enviadas para exame bacteriológico. As colheitas de urina foram requisitadas apenas nos casos de suspeita clínica de infeção do trato urinário (ITU). As variáveis analisadas foram: sexo, idade, classificação da lesão medular de acordo com ISNCSCI, antibioterapia utilizada, microrganismos isolados na urocultura, regime vesical na altura da infeção e o perfil resistência aos antibióticos.Resultados: Dos doentes, 75,9% apresentaram pelo menos uma ITU, sendo mais frequente nos doentes a utilizar técnicas de algaliação urinária. Os doentes em algaliação contínua apresentaram um número superior de ITU em relação a pacientes em algaliação intermitente. As bactérias mais frequentemente isoladas foram a Klebsiella pneumoniae (43%) e a Escherichia coli (22,8%). Das bactérias isoladas, 71,5% eram multirresistentes. As maiores taxas de incidência de infeções multirresistentes (82%) foram verificadas em doentes que se encontravam em regime de algaliação contínua (p < 0,05).Conclusão: A Klebsiella pneumoniae foi a bactéria responsável pelo maior número de ITU’s. Os resultados deste estudo estão de acordo com a literatura que descreve resistências crescentes aos antimicrobianos e aumento de infeções multirresistentes na população com lesão medular. A algaliação intermitente é preferível à algaliação contínua, visto que a maioria das ITU’s foi encontrada em pacientes com algaliação contínua. Pacientes AIS D e em micção espontânea apresentaram baixa incidência de ITU’s. Este estudo permite-nos refletir sobre a problemática do aumento exponencial da resistência aos antimicrobianos e necessidade de desenvolver outras estratégias para a prevenção de ITU’s.Sociedade Portuguesa de Medicina Física e de Reabilitação2020-01-01T00:00:00Zjournal articlejournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.25759/spmfr.262oai:ojs.spmfrjournal.org:article/262Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 31, n. 4 (2019): Ano 27; 13-180872-9204reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://spmfrjournal.org/index.php/spmfr/article/view/262https://doi.org/10.25759/spmfr.262https://spmfrjournal.org/index.php/spmfr/article/view/262/184Copyright (c) 2020 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitaçãohttp://creativecommons.org/licenses/by-nc-nd/4.0info:eu-repo/semantics/openAccessCaetano, Pedro; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, PortugalCampos, Ines; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, PortugalVilaça, José; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, PortugalMargalho, Paulo; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, PortugalLains, Jorge; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal2022-09-20T15:28:43Zoai:ojs.spmfrjournal.org:article/262Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:51:17.888800Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit Avaliação das Infecções do Trato Urinário e a Resistência Antimicrobiana numa Unidade de Reabilitação de Lesionados Medulares |
title |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit |
spellingShingle |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit Caetano, Pedro; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Drug Resistance, Multiple, Bacterial; Spinal Cord Injuries/complications; Urinary Tract Infections Farmacorresistência Bacteriana Múltipla; Infecções Urinárias; Lesões Medulares/complicações Caetano, Pedro; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Drug Resistance, Multiple, Bacterial; Spinal Cord Injuries/complications; Urinary Tract Infections Farmacorresistência Bacteriana Múltipla; Infecções Urinárias; Lesões Medulares/complicações |
title_short |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit |
title_full |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit |
title_fullStr |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit |
title_full_unstemmed |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit |
title_sort |
Assessment of Urinary Tract Infections and Antimicrobial Resistance in a Spinal Cord Injury Rehabilitation Unit |
author |
Caetano, Pedro; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal |
author_facet |
Caetano, Pedro; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Caetano, Pedro; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Campos, Ines; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Vilaça, José; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Margalho, Paulo; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Lains, Jorge; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Campos, Ines; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Vilaça, José; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Margalho, Paulo; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Lains, Jorge; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal |
author_role |
author |
author2 |
Campos, Ines; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Vilaça, José; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Margalho, Paulo; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Lains, Jorge; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Caetano, Pedro; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Campos, Ines; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Vilaça, José; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Margalho, Paulo; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal Lains, Jorge; Centro de Medicina de Reabilitação da Região Centro - Rovisco Pais, Tocha, Portugal |
dc.subject.por.fl_str_mv |
Drug Resistance, Multiple, Bacterial; Spinal Cord Injuries/complications; Urinary Tract Infections Farmacorresistência Bacteriana Múltipla; Infecções Urinárias; Lesões Medulares/complicações |
topic |
Drug Resistance, Multiple, Bacterial; Spinal Cord Injuries/complications; Urinary Tract Infections Farmacorresistência Bacteriana Múltipla; Infecções Urinárias; Lesões Medulares/complicações |
description |
Introduction: Our objective was the identification and characterization of the bacterial spectrum and of its susceptibility to antibiotics in patients treated in a Spinal Cord Injury Unit. The determination of the role played in the infections by the vesical emptying method and the medullar injury, as classified by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI).Material and Methods: We retrospectively analyzed 79 patients who had been hospitalized in a Spinal Cord Injury Unit between 1/09/2014 and 1/09/2015. One hundred and fifty-eight urine samples were collected and sent for bacteriological examination. The urine samples were collected only in cases where there was clinical suspicion of a UTI. The variables taken into account were: gender, age, ISCNCSCI classification, antibiotic therapy applied, microorganisms isolated in the urine cultures, the method employed to bladder emptying at the time of the infection, and the profile of resistance to antibiotics.Results: We found that 75.9% of patients contracted at least one UTI in our Spinal Cord Injury Unit, with a higher frequency detected among those subjected to a urinary catheterization technique. Patients undergoing continuous catheterization presented a higher number of UTIs than those on intermittent catheterization. The most common bacteria isolated were Klebsiella pneumoniae (43%) and Escherichia coli (22.8%). We determined that 71.5% of the isolated bacteria were multidrug-resistant. The highest rates of resistance (82%) were found among patients undergoing continuous catheterization (p < 0.05).Conclusion: Klebsiella pneumoniae was the most frequent bacterial cause of UTIs in our unit. Our results are consistent with scientific reports describing increasingly higher levels of bacterial resistance to drugs, as well as a higher rate of multi-resistant infections within the population with SCI. Intermittent catheterization is preferable, since most UTIs were reported among patients undergoing continuous catheterization. AIS D patients, and those with spontaneous urination, exhibited a lower rate of infection. These results are food for thought on the antimicrobial resistance of bacteria and on the need for the development of alternative strategies to prevent UTIs. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-01-01T00:00:00Z |
dc.type.driver.fl_str_mv |
journal article journal article info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25759/spmfr.262 oai:ojs.spmfrjournal.org:article/262 |
url |
https://doi.org/10.25759/spmfr.262 |
identifier_str_mv |
oai:ojs.spmfrjournal.org:article/262 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://spmfrjournal.org/index.php/spmfr/article/view/262 https://doi.org/10.25759/spmfr.262 https://spmfrjournal.org/index.php/spmfr/article/view/262/184 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação http://creativecommons.org/licenses/by-nc-nd/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação http://creativecommons.org/licenses/by-nc-nd/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Física e de Reabilitação |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Física e de Reabilitação |
dc.source.none.fl_str_mv |
Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação; v. 31, n. 4 (2019): Ano 27; 13-18 0872-9204 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1822226728900100096 |
dc.identifier.doi.none.fl_str_mv |
10.25759/spmfr.262 |