Document Detail


Diagnostic criteria of urinary tract infection in male patients with spinal cord injury.
MedLine Citation:
PMID:  21131625     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: . The current diagnostic criteria of urinary tract infection (UTI) in male patients with spinal cord injury (SCI) are not clear.
METHODS: . The authors studied 381 episodes of "symptomatic" UTI (209 participants) and 277 episodes of "asymptomatic" UTI (205 participants) in male SCI patients using intermittent catheterization. UTI was defined as a bacterial count ≥10(2) colony-forming units (cfu)/mL (American Paraplegia Society criterion). Univariate analysis and receiver operating characteristic (ROC) curve analysis were used to determine optimal cfu and white blood cell (WBC) thresholds.
RESULTS: . The most prevalent clinical signs, alone or in combination, were cloudy and/or malodorous urine (51.4%), onset of urinary incontinence (51.2%), fatigue (41.7%), fever (30.7%), and increased spasticity (30.2%). Urine cfu and WBC levels in patients with only one sign, including fever, were not significantly higher than those in asymptomatic controls. WBC, but not cfu, levels increased significantly with the number of signs (P = .026). Univariate analysis and ROC curve analysis failed to identify cfu, WBC, or a combination of cfu and WBC count thresholds, allowing discrimination between the symptomatic and asymptomatic UTI groups.
CONCLUSIONS: . Clinical signs of UTI correlate poorly with the urine cfu and WBC levels in SCI patients, except for a positive relationship between WBC counts and the number of signs. Fever alone has no higher diagnostic value. There are no satisfactory cfu and WBC thresholds: thresholds more restrictive than the current American Paraplegia Society criteria provide higher specificity values but with equivalent loss of sensitivity.
Authors:
Esthel Ronco; Pierre Denys; Claire Bernède-Bauduin; Isabelle Laffont; Patricia Martel; Jérôme Salomon; Bernard Bussel; Didier Guillemot; Jean-Louis Gaillard
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Publication Detail:
Type:  Journal Article     Date:  2010-12-03
Journal Detail:
Title:  Neurorehabilitation and neural repair     Volume:  25     ISSN:  1552-6844     ISO Abbreviation:  Neurorehabil Neural Repair     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-03-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892086     Medline TA:  Neurorehabil Neural Repair     Country:  United States    
Other Details:
Languages:  eng     Pagination:  351-8     Citation Subset:  IM    
Affiliation:
1Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France.
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