TY - JOUR
T1 - UTIs in Patients with Neurogenic Bladder
AU - Jahromi, Mona S.
AU - Mure, Amanda
AU - Gomez, Christopher S.
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media New York.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Urinary tract infections (UTI) remain one of the most prevalent and frustrating morbidities for neurogenic bladder patients, and death attributed to urosepsis in the spinal cord injury (SCI) patient is higher when compared to the general population. Risk factors include urinary stasis, high bladder pressures, bladder stones, and catheter use. While classic symptoms of UTI include dysuria, increased frequency and urgency, neurogenic bladder patients present differently with increased spasticity, autonomic dysreflexia, urinary incontinence, and vague pains. Multiple modalities have been assessed for prevention including catheter type, oral supplements, bladder irrigation, detrusor injections and prophylactic antimicrobials. Of these, bladder inoculation with E. coli HU2117, irrigation with iAluRil®, detrusor injections, and weekly prophylaxis with alternating antibiotics appear to have a positive reduction in UTI but require further study. Ultimately, treatment for symptomatic UTI should account for the varied flora and possible antibiotic resistances including relying on urine cultures to guide antibiotic therapy.
AB - Urinary tract infections (UTI) remain one of the most prevalent and frustrating morbidities for neurogenic bladder patients, and death attributed to urosepsis in the spinal cord injury (SCI) patient is higher when compared to the general population. Risk factors include urinary stasis, high bladder pressures, bladder stones, and catheter use. While classic symptoms of UTI include dysuria, increased frequency and urgency, neurogenic bladder patients present differently with increased spasticity, autonomic dysreflexia, urinary incontinence, and vague pains. Multiple modalities have been assessed for prevention including catheter type, oral supplements, bladder irrigation, detrusor injections and prophylactic antimicrobials. Of these, bladder inoculation with E. coli HU2117, irrigation with iAluRil®, detrusor injections, and weekly prophylaxis with alternating antibiotics appear to have a positive reduction in UTI but require further study. Ultimately, treatment for symptomatic UTI should account for the varied flora and possible antibiotic resistances including relying on urine cultures to guide antibiotic therapy.
KW - Clean intermittent catheterization
KW - Multiple sclerosis
KW - Neurogenic bladder
KW - Spinal cord injury
KW - UTI prophylaxis
KW - Urinary tract infection
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U2 - 10.1007/s11934-014-0433-2
DO - 10.1007/s11934-014-0433-2
M3 - Review article
C2 - 25113150
AN - SCOPUS:84957440408
VL - 15
SP - 1
EP - 7
JO - Current Urology Reports
JF - Current Urology Reports
SN - 1527-2737
IS - 9
M1 - 433
ER -