Prevention and Management of Urinary Tract Infections in Paralyzed Persons.211 Evidence Report/Technology Assessment Number 6

摘要

The specific questions addressed in this report are (1) what combination of211u001esigns, symptoms, and laboratory findings are associated with risks to persons 211u001ewith paralysis due to neurogenic bladder, (2) what are risk factors for recurrent 211u001eUTIs, and (3) what are the risks and benefits of antibiotic prophylaxis. The 211u001eliterature review for the first key question was broad and included studies of 211u001eboth short-term and long-term risks as related to episodes of various 211u001ecombinations of signs, symptoms, and laboratory findings, for example, the 211u001epresence of fever, the level of bacteriuria, the type or organism, the presence 211u001eof varying levels of pyuria, or some combination. For the literature search on 211u001erisk factors for UTI, types of risk factors examined were socioeconomic status, 211u001einsurance status, behavioral factors, personal hygiene, sex, and domicile, as 211u001ewell as intermediate risk factors of bladder management method (or drainage), 211u001etime since injury, and level of functioning (or injury). Regarding prophylaxis, 211u001ethe efficacy of any oral antibiotic therapy and the efficacy of specific oral 211u001eantibiotics were examined. All analyses were further stratified by acute versus 211u001enon-acute spinal cord injury (SCI) patients and by asympomatic and symptomatic 211u001eUTIs.