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Rates of Urinary Tract Infections in Acute Spinal Cord Injury Patients with Neurogenic Bladder Managed with Intermittent Catheterization versus Indwelling Foley

Lavina Jethani, MD (Temple University Hospital/Moss Rehabilitation PM&R Program, Philadelphia, PA, United States); Richa Lamba, MD; Marlyn Ramos Lamboy, MD

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Friday, November 15, 2019

Session Title: Neurological Rehabilitation Research Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 6

Disclosures: Lavina Jethani, MD: Nothing to disclose

Objective: To test the hypothesis that patients with acute (defined as less than or equal to 1 month since initial injury) spinal cord injury (SCI) with neurogenic bladder (NB) were more likely to develop a urinary tract infection (UTI) if managed with clean intermittent catheterization (CIC) versus indwelling Foley catheter (IFC).

Design: Retrospective, cohort

Setting: SCI Inpatient Rehabilitation Unit (IPR)

Participants: All admissions (261) between April 1, 2017 and March 31, 2018 to IPR were reviewed. Fifty were excluded due to not having SCI, 50 were excluded due to not being acutely injured. Of the 161 remaining, 67 had NB: 27 traumatic acute spinal cord injury (TSCI) and 40 nontraumatic spinal cord injury (NTSCI).

Interventions: Retrospective chart review revealed which acute SCI patients with NB were diagnosed with a UTI during admission and the mode of NB management at time of UTI: IFC, CIC, suprapubic catheter (SPC), or noninvasive means (NIM).

Main Outcome Measures: Number with NB; total number with UTI; number with NB that developed UTI; number of UTI associated with IFC; and number of UTI associated with IC.

Results: Overall rate of UTI in acute SCI patients was 24%. Of the 67 patients with NB, 28 (42%) developed UTI. Of those 28 patients, 5 (18%) were being managed with IFC, 18 (64%) were being managed with CIC, and 5 (18%) were being managed by NIM (timed voids, condom catheter, medications) at the time of UTI. One acute SCI patient with NB received SPC and did not have a UTI.

Conclusions: In this cohort of acute TSCI and NTSC patients with NB, the incidence of a UTI related to an IFC was no greater than NIM management. The number of UTIs related to CIC was three times greater. A large percentage of UTIs diagnosed in IPR in acute SCI patients with NB are related to the use of CIC.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Jethani L, Lamba R, Lamboy MR. Rates of Urinary Tract Infections in Acute Spinal Cord Injury Patients with Neurogenic Bladder Managed with Intermittent Catheterization versus Indwelling Foley [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/rates-of-urinary-tract-infections-in-acute-spinal-cord-injury-patients-with-neurogenic-bladder-managed-with-intermittent-catheterization-versus-indwelling-foley/. Accessed May 22, 2025.
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