Archives of Physical Medicine and Rehabilitation
Volume 81, Issue 6 , Pages 764-769, June 2000

Antimicrobial resistance in gram-negative bacteria isolated from the urinary tract in community-residing persons with spinal cord injury☆☆★★

Presented in part at the 25th Annual Meeting of the American Spinal Injury Association, April 1999, Atlanta, GA.

Departments of Physical Medicine and Rehabilitation (Waites, Chen, DeVivo, Canupp) and Pathology (Waites, Moser), University of Alabama at Birmingham, Birmingham, AL.

Received 19 April 1999; accepted 22 December 1999.

Abstract 

Waites KB, Chen Y-Y, DeVivo MJ, Canupp KC, Moser SA. Antimicrobial resistance in gram-negative bacteria isolated from the urinary tract in community-residing persons with spinal cord injury. Arch Phys Med Rehabil 2000;81:764-9. Objective: To assess the epidemiology of antimicrobial resistance among community-residing persons with spinal cord injury (SCI). Design: Retrospective analysis of existing data. Setting: Data were obtained from persons with SCI attending clinic for annual examinations. Participants: Two hundred eighty-seven SCI outpatients. Intervention: None. Main Outcome Measure: Occurrence of bacteriuria with gram-negative organisms demonstrating resistance to antimicrobial agents in 2 or more classes. Results: There were 706 gram-negative isolates from 444 urine specimens. Resistance to drugs in 2 or more classes occurred in 33% of bacterial isolates, but did not significantly increase in frequency among those injured for longer periods or more severely. Significantly higher rates of multidrug-resistant bacteria occurred in specimens from males, younger age group (≤45yrs), and persons with indwelling and condom catheters. Conclusions: Antimicrobial resistance in outpatients with SCI is common and is related to widespread use of specific drugs, type of bladder management, and other host factors. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Keywords:  Spinal cord injuries, Urinary tract infections, Bacteriuria, Drug resistance, microbial, Rehabilitation

 

 Supported by grant 1688 from the Paralyzed Veterans of America Spinal Cord Research Foundation and grant H133B980016 from the National Institute on Disability and Rehabilitation Research.

☆☆ No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

 Reprint requests to Ken B. Waites, MD, Department of Pathology WP 230, 618 South 18th Street, Birmingham, AL 35233.

★★ Supplier

 a. Dade MicroScan, Inc., 1584 Enterprise Blvd, West Sacramento, CA 95691.

PII: S0003-9993(00)90108-4

doi:10.1016/S0003-9993(00)90108-4

Archives of Physical Medicine and Rehabilitation
Volume 81, Issue 6 , Pages 764-769, June 2000