Advertisement

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

      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Stover SL
        • Lloyd LK
        • Waites KB
        • Jackson A
        Urinary tract infection in spinal cord injury.
        Arch Phys Med Rehabil. 1989; 70: 47-54
      1. Clinical outcomes from the model systems. Aspen, Gaithersburg (MD)1995
        • Archibald L
        • Phillips I
        • Monnet D
        • McGowan JE
        • Tenover F
        • Gaynes R
        Antimicrobial resistance in isolates from inpatients and outpatients in the United States: increasing importance of the intensive care unit.
        Clin Infect Dis. 1997; 24: 211-215
        • Taylor TA
        • Waites KB
        A quantitative study of genital skin flora in male spinal cord injured outpatients.
        Am J Phys Med Rehabil. 1993; 72: 117-121
        • Gribble MJ
        • Puterman ML
        Prophylaxis of urinary tract infection in persons with recent spinal cord injury: a prospective randomized double blind, placebo-controlled study of trimethoprim-sulfamethoxazole.
        Am J Med. 1993; 95: 141-152
        • Waites KB
        • Canupp KC
        • DeVivo MJ
        Epidemiology and risk factors for urinary tract infection following spinal cord injury.
        Arch Phys Med Rehabil. 1993; 74: 691-695
        • NIDRR Consensus Statement
        J Am Paraplegia Soc. 1992; 15: 194-204
        • Gribble MJ
        • McCallum NM
        • Schechter MT
        Evaluation of diagnostic criteria for bacteriuria in acutely spinal cord injured patients undergoing intermittent catheterization.
        Diagn Microbiol Infect Dis. 1988; 9: 197-206
        • National Committee for Clinical Laboratory Standards (USA)
        Performance standards for antimicrobial susceptibility testing. 15. NCCLS, Villanova (PA)1995 (6th informational supplement M100-S6)
        • Diggle PJ
        • Liang KY
        • Zeger SL
        The analysis of longitudinal data.
        Oxford University Press, New York1994
        • Montgomerie JZ
        Infections in patients with spinal cord injuries.
        Clin Infect Dis. 1997; 25: 1285-1292
        • Fawcett C
        • Chawla JC
        • Quoraishi A
        • Stickler DJ
        A study of the skin flora of spinal cord injured patients.
        J Hosp Infect. 1986; 8: 149-158
        • Cardenas DD
        • Hooton TM
        Urinary tract infection in persons with spinal cord injury.
        Arch Phys Med Rehabil. 1995; 76: 272-280
        • Montgomerie JZ
        • Morrow JW
        Pseudomonas colonization in patients with spinal cord injury.
        Am J Epidemiol. 1978; 108: 328-336
        • Waites KB
        • Canupp KC
        • Brookings ES
        • DeVivo MJ
        Effect of oral ciprofloxacin on bacterial flora of perineum, urethra, and lower urinary tract in men with spinal cord injury.
        J Spinal Cord Med. 1999; 22: 192-198
        • Sanderson PJ
        • Rawal P
        Contamination of the environment of spinal cord injured patients by organisms causing urinary tract infection.
        J Hosp Infect. 1987; 10: 173-178
        • Darouiche RO
        • Priebe M
        • Clarridge JE
        Limited versus full microbiological investigation for the management of symptomatic polymicrobial urinary tract infection in adult spinal cord-injured patients.
        Spinal Cord. 1997; 35: 534-539
        • Newman E
        • Price M
        Bacteriuria in patients with spinal cord lesions: its relationship to urinary drainage appliances.
        Arch Phys Med Rehabil. 1977; 58: 427-430
        • Montgomerie JZ
        Infections in patients with spinal cord injuries.
        Clin Infect Dis. 1997; 25: 285-292
        • Bennett CJ
        • Young MN
        • Darrington H
        Differences in urinary tract infections in male and female spinal cord injury patients on intermittent catheterization.
        Paraplegia. 1995; 33: 69-72
        • Pedersen SS
        • Horbov S
        • Biering-Sorensen F
        • Hoiby N
        Peroral treatment with ciprofloxacin of patients with spinal cord lesion and bacteriuria caused by multiply resistant bacteria.
        Paraplegia. 1990; 28: 41-47
        • Stannard AJ
        • Sharples SJ
        • Norman PM
        • Tillotson GS
        Ciprofloxacin therapy of urinary tract infections in paraplegic and tetraplegic patients: a bacteriological assessment.
        J Antimicrobial Chemother. 1990; 26: 13-18
        • Biering-Sorensen F
        • Hoiby N
        • Nordenbo A
        • Ravenborg M
        • Bruun B
        • Rahm V
        Ciprofloxacin as prophylaxis for urinary tract infection: prospective, randomized, cross-over, placebo-controlled study in patients with spinal cord lesion.
        J Urol. 1994; 151: 105-108
        • Waites KB
        • Canupp KC
        • DeVivo MJ
        Eradication of urinary tract infections following spinal cord injury.
        Paraplegia. 1993; 31: 645-652
        • Waites KB
        • Canupp KC
        • DeVivo MJ
        Efficacy and tolerance of norfloxacin in the treatment of urinary tract infections in patients with neurogenic bladder secondary to spinal cord injury.
        Urology. 1991; 38: 589-596
        • Sandock DS
        • Gothe BG
        • Bodner DR
        Trimethoprim-sulfamethoxazole prophylaxis against urinary tract infection in the chronic spinal cord injury patient.
        Paraplegia. 1995; 33: 156-160
        • Savitz DA
        • Olshan AF
        Multiple comparisons and related issues in the interpretation of epidemiologic data.
        Am J Epidemiol. 1995; 142: 904-908