Antimicrobial resistance in gram-negative bacteria isolated from the urinary tract in community-residing persons with spinal cord injury

Objective: To assess the epidemiology of antimicrobial resistance among com munity-residing persons with spinal cord injury (SCI). Design: Retrospective analysis of existing data. Setting: Data were obtained from persons with SCI attending clinic for annu al examinations. Participants: Two hundred eighty-seven SCI outpatients. Intervention: None. Main Outcome Measure: Occurrence of bacteriuria with grain-negative organis ms demonstrating resistance to antimicrobial agents in 2 or more classes. Results: There were 706 gram-negative isolates from 444 urine specimens. Re sistance to drugs in 2 or more classes occurred in 33% of bacterial isolate s, but did not significantly increase in frequency among those injured for longer periods or more severely. Significantly higher rates of multidrug-re sistant bacteria occurred in specimens from males, younger age group (less than or equal to 45yrs), and persons with indwelling and condom catheters. Conclusions: Antimicrobial resistance in outpatients with SCI is common and is related to widespread use of specific drugs, type of bladder management , and other host factors.