Open Access

ARTICLE

Factors associated with recurrent urinary tract infections in spinal cord injured patients who use intermittent catheterization

Ross G. Everett, David K. Charles, Halle E. Foss, R. Corey O’Connor, Michael L. Guralnick

Department of Urologic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Address correspondence to Dr. Michael L Guralnick, DepartmentofUrologicSurgery,MedicalCollegeofWisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA

Canadian Journal of Urology 2021, 28(6), 10920-10928.

Abstract

Introduction: Urinary Tract Infection (UTI) has been cited as the primary cause of morbidity in patients with a history of spinal cord injury (SCI). Despite the significance of recurrent UTI (rUTI) in this population, the causative physiologic and patient characteristics are not well described. We sought to assess associations between demographic, clinical, and urodynamic variables and rUTI.
Materials and methods: The records of 136 individuals with SCI who perform clean intermittent catheterization (CIC) were retrospectively reviewed. All had a video urodynamics study (VUDS) available for analysis. Individuals were divided into non-recurrent (< 3/year) or rUTI (≥ 3/year) groups. Differences between the cohorts were analyzed. Multivariable logistic regression was performed to determine associations between various demographic, clinical, and VUDS variables and rUTI.
Results: Self-reported rUTI were noted in 58 of 136 individuals. Of 124 individuals with urinary culture results, African American race (43.3% vs. 22.3%) and ‘Other’ race (13.3% vs. 8.5%) made up larger proportions in the rUTI group. Female gender (OR 4.96, 95% CI [1.44-17.13]) and African American race (OR 5.16, 95% CI [1.80-14.79]) were increasingly associated with rUTI on multivariable logistic regression. Shorter interval since injury was also significantly associated with recurrent infections, with each year since injury indicating diminished likelihood (OR 0.91, 95% CI [0.82-0.99]). There were no significant differences in VUDS variables between groups, and none were significant on regression as potential determinants of rUTI.
Conclusions: Patient race, gender, and time since SCI appear to have significant associations with rUTI in individuals with SCI using CIC. However, VUDS variables were not found to be significantly associated with rUTI.

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