Urinary Tract Infections in Spinal Cord Injury Patients Undergoing Intermittent Catheterization Procedures

A prospective study was organized to assess whether feeding back infection rates to staff performing intermittent catheterization in spinal cord-injured patients would produce a fall in urinary tract infection rates. Over a 12 month period, infection rates for such procedures were reported to unit staff: reporting was combined with educational programs emphasizing aseptic catheterization techniques and the importance ofhandwashing. Overall infection rates for the 12 month period were 13.3 per 1000 days of intermittent catheterization - unchanged from the preceding six months (15.1 per 1000 days) by retrospective chart review. Likewise, there was no statistically significant downward trend during the prospective phase of the study. A wide variety of infecting organisms were found, of which Klebsiella species (39%), Escherichia coli (18%) and Enterobacter species (17%) were most common: most infections were asymptomatic. Patients with complete cord lesions at or above the sixth thoracic spinal cord segment (T6) had a much higher incidence of infection (73%) than those with incomplete lesions below T6 (33%)