| 제목 |
Pyuria and bacteriuria do not increase risk of UTI after UDS with prophylactic antibiotics |
| 소속 |
National Rehabilitation Center, Department of Rehabilitation Medicine1 |
| 저자 |
Hyunsoo Shin, MD1*, Bum-Suk Lee, MD, MPH1†, Zee-A Han, MD, PhD1, Hye-Ri Kim, MD1, Seung-Won Hwang, MD1, Mira Choi1 |
Purpose
Many random urine samples of spinal cord injury patients without urinary infection symptoms present pyuria or bacteriuria. Therefore, prophylactic antibiotics are administered before urodynamic studies in our hospital.
The purpose of present study was
1. finding the percentage of incidental pyuria and bacteriuria in spinal cord injury patients
2. assessing the impact of pyuria and bacteriuria on urinary tract infection after urodynamic studies in spinal cord injury patients when prophylactic antibiotics are administered.
Objectives & methods
Patients were recruited from August 2015 to February 2016. A total 100 consecutive patients with spinal cord injury underwent urodynamic study during period were included in this study.
Pyuria was defined as 10 or more white blood cells per high power field in urine microscopic examination. Bacteriuria was defined as more than 105 colony forming units per ml in urine culture.
Urinalysis and urine culture was done within 12 hours before urodynamic study. Prophylactic antibiotics was administered orally for 5 days after sampling urine. Twenty four hours after urodynamis study, urine microscopic examination and urine culture was done again.
We designed the criteria to define symptomatic UTI based on urine microscopic examination. Symptomatic UTI was defined as presence of pyuria with newly developed fever or urethral pus discharge.
Fisher’s exact test was used to compare the incidence of symptomatic UTI after urodynamic study. The level of statistical significance was defined as p<0.05
Results
Of total 100 urine samples before urodynamic studies, pyuria was detected in 48 samples, bacteriuria was detected in 72 samples(Table 1).
Symptomatic UTI was observed after urodynamic study in 4 patients. All 4 patients had a fever. 2(4.17%) of 48 patients had pyuria and 2(3.85%) of 52 patients did not before urodynamic study present symptomatic UTI. There was no statistical difference(P=1.000) between two groups. 2(2.78%) of 72 patients had bacteriuria and 2(7.14%) of 28 patients did not before urodynamic study present symptomatic UTI. There was also no statistical difference (P=0.312) between two groups(Table 2).
Conclusion
Before UDS, asymptomatic pyuria(48%) and bacteriuria(72%) was observed in many spinal cord injury patients.
With oral prophylactic antibiotics, there was no significant difference of incidence of symptomatic UTI after urodynamic study between the patients who had pyuria or bacteriuria and patient did not before urodynamic study. |
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Table 1. Incidence of pyuria and bacteriuria
Table 2. Incidence of symptomatic UTI after UDS
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