Analiza faktora razvoja infekcije urinarnog trakta kod bolesnika sa povredom kičmene moždine

  • Aleksandra Sekulić Clinic for rehabilitation Dr M. Zotovic
  • Aleksandra Karadzov Nikolic Institute of Rheumatology, Belgrade
  • Zoran Bukumiric Institute of Statistics and Informatics, Faculty of Medicine, Belgrade
  • Goran Trajkovic Institute of Statistics and Informatics, Faculty of Medicine, Belgrade
  • Aleksandar Corac Medical Faculty Pristina, Department of preventive medicine, Kosovska Mitrovica
  • Slobodan Jankovic Institute of Pharmacology, Faculty of Medical Sciences, Kragujevac
  • Sasa Milicevic Clinic for rehabilitation Dr M. Zotovic, Belgrade
DOI: https://doi.org/10.2298/6505
Ključne reči: Urinary Tract||, ||, Prediction||, Urinary Tract Infections||, Spinal cord injury||,

Sažetak


Uvod/Cilj. Infekcije urinarnog trakta još uvek su najčešće komplikacije kod bolesnika sa povredom kičmene moždine. Cilj rada bio je da se ispitaju faktori koji mogu  uticati na razvoj urinarnih infekcija u toku rehabilitacije bolesnika sa povredom kičmene moždine. Metode. Ova retrospektivna studija slučaja obuhvatila je 540 ispitanika sa povredom kičmene moždine koji su rehabilitovani u Klinici za rehabilitaciju „Dr Miroslav Zotović“ u periodu od januara 2000. do decembra 2009. godine. Za dobijanje podataka koji su korišćeni u ovoj studiji kao što su način pražnjenja mokraćne bešike, vrsta neurološkog poremećaja mokraćne bešike, neurološki nivo i kompletnost lezije, etiologija povrede, način lečenja, sekundarne komplikacije, udružene povrede, kalkuloze bubrega i bešike, starost i pol, korišćene su istorije bolesti i ostala medicinska dokumentacija. Rezultati. Od ukupnog broja ispitanika koji su bili uključeni u ovu studiju 152 (28,1%) je bilo bez urinarnih infekcija, dok je 388 (71,9%) imalo urinarne infekcije. Bilo je 389 (72%)  muškaraca i 151 (28%) žena. Prosečna starost ispitanika bez urinarnih infekcije bila je 51,0 ± 15,4, a bolesnika sa urinarnim infekcijama 44,3 ± 16,9 godina. Rezultati naše studije ukazuju na to da su faktori koji najviše doprinose razvoju urinarnih infekcija tokom rehabilitacije bolesnika sa povredom kičmene moždine udružene povrede (OR = 3,5), anemija (OR = 5,67), način pražnjenja mokraćne bešike (OR = 40–60) i kristali u urinu (OR = 7,54). Zaključak. Kliničari bi trebalo da sprovedu ranu dijagnostiku i adekvatno terapijsko lečenje infekcija urinarnog trakta kod osoba sa povredom kičmene moždine i poremećajem pražnjenja mokraćne bešike, kombinovanim povredama, anemijom i kristalima u urinu.

 

Ključne reči:

kičmena moždina, povrede; urinarni trakt, infekcije; faktori rizika; kateterizacija urinarnog trakta; povrede, multiple; anemija; rehabilitacija.

Reference

Wyndaele M, Wyndaele J. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey. Spinal Cord 2006; 44(9): 523−9.

Sekhon LH, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine 2001; 26(24 Suppl): S2−12.

Adriaansen JJ, van Asbeck FW, Lindeman E, van der Woude LH, de Groot S, Post MW. Secondary health conditions in persons with a spinal cord injury for at least 10 years: design of a comprehensive long-term cross-sectional study. Disabil Rehabil 2013; 35(13): 1104−10.

Ploypetch T, Dajpratham P, Assanasen S, Thanakiatpinyo T, Tanvijit P, Karawek J. Epidemiology of urinary tract infection among spinal cord injured patients in rehabilitation ward at Siriraj Hospital. J Med Assoc Thai 2013; 96(1): 99−106.

Togan T, Azap OK, Durukan E, Arslan H. The prevalence, etiologic agents and risk factors for urinary tract infection among spinal cord injury patients. Jundishapur J Microbiol 2014; 7(1): e8905.

Nicolle LE. Urinary tract infections in patients with spinal injuries. Curr Infect Dis Rep 2014; 16(1): 390.

Li L, Ye W, Ruan H, Yang B, Zhang S, Li L. Impact of hydrophilic catheters on urinary tract infections in people with spinal cord injury: systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil 2013; 94(4): 782−7.

Afsar SI, Yemisci OU, Cosar SN, Cetin N. Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study. Spinal Cord 2013; 51(8): 645−9.

DeJong G, Tian W, Hsieh CH, Junn C, Karam C, Ballard PH, et al. Rehospitalization in the first year of traumatic spinal cord injury after discharge from medical rehabilitation. Arch Phys Med Rehabil 2013; 94(4 Suppl): S87−97.

Wu Q, Ning GZ, Li YL, Feng HY, Feng SQ. Factors affecting the length of stay of patients with traumatic spinal cord injury in Tianjin, China. J Spinal Cord Med 2013; 36(3): 237−42.

Abrams P. Urodynamics. 3rd ed. London: Springer-Verlag Limited; 2006.

American Spinal Injury Association/International Medical Society of Paraplegia (ASIA/IMSOP). International Standards for Neurological and Functional Classification of Spinal Cord Injury (Revised edition). Chicago: American Spinal Injury Association; 2000.

Kirshblum SC, Memmo P, Kim N, Campagnolo D, Millis S; American Spinal Injury Association. Comparison of the revised 2000 American Spinal Injury Association classification standards with the 1996 guidelines. Am J Phys Med Rehabil 2002;8 1(7): 502−5.

Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther 1987; 67(2): 206−7.

Aitkens S, Lord J, Bernauer E, Fowler WM, Lieberman JS, Berck P. Relationship of manual muscle testing to objective strength measurements. Muscle Nerve 1989; 12(3): 173−7.

Balsara ZR, Ross SS, Dolber PC, Wiener JS, Tang Y, Seed PC. Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder. Infect Immun 2013; 81(8): 3018−26.

Jeong SJ, Cho SY, Oh SJ. Spinal cord/brain injury and the neurogenic bladder. Urol Clin North Am 2010; 37(4): 537−46.

Van Gool J, Tanagho EA. External sphincter activity and recurrent urinary tract infection in girls. Urology 1977; 10(4): 348−53.

Nazarko L. Management of a patient with diabetes and a hypotonic bladder. Nurs Times 2005; 101(47): 63−4.

Dunne JR, Malone D, Tracy JK, Gannon C, Napolitano LM. Perioperative anemia: an independent risk factor for infection, mortality, and resource utilization in surgery. J Surg Res 2002; 102(2): 237−44.

Grossman RG, Frankowski RF, Burau KD, Toups EG, Crommett JW, Johnson MM, at al. Incidence and severity of acute complications after spinal cord injury. J Neurosurg Spine 2012; 17(1 Suppl): 119−28.

Cuttitta F, Torres D, Vogiatzis D, Buttà C, Bellanca M, Gueli D, et al. Obesity and iron deficiency anemia as risk factors for asymptomatic bacteriuria. Eur J Intern Med 2014; 25(3): 292−5.

Rathor N, Khillan V, Sarin SK. Nosocomial candiduria in chronic liver disease patients at a hepatobilliary center. Indian J Crit Care Med 2014; 18(4): 234−7.

Dibua UM, Onyemerela IS, Nweze EI. Frequency, urinalysis and susceptibility profile of pathogens causing urinary tract infections in Enugu State, southeast Nigeria. Rev Inst Med Trop Sao Paulo 2014; 56(1): 55−9.

Torzewska A, Budzyńska A, Białczak-Kokot M, Różalski A. In vitro studies of epithelium-associated crystallization caused by uropathogens during urinary calculi development. Microb Pathog 2014; 71−72: 25−31.

Objavljeno
2017/01/20
Broj časopisa
Vol. 72 Br. 12 (2015)
Rubrika
Originalni članak