Comparison Between Prevalence Organisms Causing Urinary Treat Infection in Spinal Cord Injured and Urinary Catheterized Patients Hospitalized in Al-Zahra Hospital, Isfahan

Introduction. Spinal cord injury leads to increased incidence of urinary infection because of sensory and motor derangements as well as alteration in function of urinary system. Pathogenic factors vary based on differences in geographic regions. Urinary infection in the most common nosocomial infection and more that 80% of its cases are due to urinary catheters. In this study, bacteria causing urinary infection in spinal cord injured and hospitalized patients have been investigated. Material & Methods. In this descriptive analytic study which was performed from 1384 to 1385, patients were divided in to groups A and B. Group A consisted of 145 spinal cord injured patients who were unable to void bladder naturally and had presented to Al-Zahra hospital, Isfahan due to symptoms of urinary infection. There were 150 hospitalized men with urinary catheter in group B without fever or urinary symptoms at the time of hospitalization that developed symptoms of urinary infection after 48 hours of admission. After completing questionnaire, urine samples were obtained from each person according to bladder voiding method and quickly sent for analysis plus culture. Patients who had taken antibiotics within the preceding 2 weeks were omitted from study. For evaluation of pyuria in diagnosis of urinary infection, patients were divided into 2 groups, one with urinary symptoms and negative urine cultures and the other with urinary symptoms but with positive urine cultures. Statistical analysis was performed using SPSS (version13) software. P<0.05 was considered significant and meaningful difference. Results. The age range of patients under study in group A was 34-54 and in group B was 40-58. There were 120 culture positive cases in group A. According to results obtained from culture of urine samples in spinal cord injured patients, the organisms isolated were E. Coli 64 cases (43.8%), Klebsiella 24 cases(16.4%), Enterococci 11 cases(7.5%), Pseudomonas aeroginosa 10 cases(6.8%), Staphylococcus aureus 5 cases(3.4%), Serratia 3 cases(2.1%), Staphylococcus epidermidis 2 cases (1.4%) and proteus 1 case (0.7%). Most of positive urine cultures were detected in patients who used indwelling catheters. There was a meaningful relation between pyuria and urinary infection (P<0.05). Results of urine cultures from hospitalized patients were as follows: E.coli 85 cases(56.7%), Klebsiella 24 cases(16%), Enterococci 15 cases(10%), Pseudomonas aeroginosa 12 cases(8%), Coagulase negative staphylococci 5 cases (3.3%) and 9 cases (6%) of Staphylococcus aureus, Serratia and Proteus. Discussion. According to the results of this study, the most common organisms causing urinary infection were similar in the two groups and included Escherichia coli, %), Klebsiella, Enterococcus and Pseudomonas in decreasing order of frequency. This similarity could lead us to similar approached to the two groups. One the other hand, colonization of nosocomial organisms in spinal cord injured patients, probably occurs because of repeated hospitalization and catheterization at hospital.