DIFFERENCES IN URINARY-TRACT INFECTIONS IN MALE AND FEMALE SPINAL-CORD INJURY PATIENTS ON INTERMITTENT CATHETERIZATION

Intermittent catheterization has gained wide acceptance for use in hos pitalized patients following spinal cord injury. Most studies evaluati ng this procedure, however, look only at the infection rate in the mal e SCI population. In this study the rate and type of infection encount ered in the male and female SCI population were evaluated in an inpati ent hospital environment. Fifty four patients who were undergoing inte rmittent catheterization with the MMG/O'Neil catheter system were eval uated. All patients were similar with regard to level of injury and bl adder management. There were 45 males and nine females in our study gr oup (n = 54). A total of 10945 catheterizations were performed with 75 infections indentified. The overall infection rate was 0.68% or one i nfection for every 146 catheterizations. Of the 45 males there were 58 infections of which 11 (18%) were E. coli. This contrasts with the fe male population (9) in which there were 17 infections with nine (53%) being E. coli. While a variety of infecting organisms were present in males, females were colonized with either E. coli, enterococcus or Kle bsiella. While hospital based intermittent catheterization would appea r to be associated with an acceptable low incidence of urinary tract i nfections (0.68%), infected females have a higher incidence of E. coli (53%) compared to the male population (18%). This study also demonstr ated that female patients had a significantly higher infection rate th an males (nine females with 17 infections compared to 45 males with 58 infections over the same time period). The higher incidence of urinar y tract infections in females with E. coli perhaps is related to the p roximity of bowel/stool contamination.