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Bacterial urine profile and optimal urine specimen collection timing in asymptomatic chronically catheterized adults with spinal cord injuries and disorders

Published:September 17, 2021DOI:https://doi.org/10.1016/j.ajic.2021.09.007

      Highlights

      • Urinary samples, even when collected after catheter change, are always colonized.
      • Urine collected 1hr. post-catheter change shows the least pyuria and bacterial growth.
      • Improved practice guidelines are necessary for chronic urinary catheterization.

      Background

      Adults with spinal cord injuries and disorders (SCI/D) require chronic indwelling catheterization which is associated with an increased risk of catheter-associated (CA) adverse events.

      Methods

      We studied urine samples (culture and urinalysis) from 2 cohorts of chronically catheterized males with SCI/D. Cohort 1 included 28 participants; 3 samples per patient were collected (before, after, and 7 days after catheter change). Cohort 2 included 21 participants; 7 samples per patient were collected (before, immediately after, 30 minutes, 1 hour, 1 day, 2 days, and 7 days after catheter change).

      Results

      A statistically significant decrease in the post catheter change percentage of “significant cultures” was found in both our cohorts (P<.05). Additionally, our second cohort demonstrated a significant decrease in the number of organisms growing at 100.000 cfu/mL (median=-1, mean=-1.5, P=.0006) and in urinalysis bacterial numbers (median=-0.5, mean=-1, P=.006) from pre- to 1-hour post catheter removal.

      Conclusions

      Although there appears to be an improvement of organism burden seen after catheter change, this is only temporary, and its significance in chronically catheterized patients is still unknown. Our second cohort demonstrated an optimal time for sample collection at the 1-hour post-catheter change sample, but further research is required for the extrapolation of these findings.

      Key Words

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