การศึกษาความชุกทางเดินปัสสาวะติดเชื้อในผู้ที่ไขสันหลัง บาดเจ็บเรื้อรังและใช้หลอดสวนซิลิโคนชนิดใช้ซ้ำด้วยเทคนิค สะอาด
การศึกษาความชุกทางเดินปัสสาวะติดเชื้อในผู้ที่ไขสันหลัง บาดเจ็บเรื้อรังและใช้หลอดสวนซิลิโคนชนิดใช้ซ้ำด้วยเทคนิค สะอาด
Keywords:
re-usable silicone catheter, clean intermittent self catheterization, spinal cord injury, urinary tract infection, prevalenceAbstract
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Objectives: To study the prevalence of urinary tract infection (UTI) in chronic spinal cord injury (SCI) individuals who used a re-usable silicone catheter for clean intermittent self catheterization (CISC) and factors related with UTI.
Design: A cross-sectional study
Setting: Urodynamic unit, Rehabilitation ward, Maharaj Nakorn Chiang Mai Hospital
Subjects: Individuals with SCI age at least 18 years old who used a re-usable silicone catheter (Fuji System Co.) for CISC at least one year and attended for urodynamic yearly check-up.
Methods: Subjects completed the International Spinal Cord Injury data sets. Urine culture was taken and urine analysis was tested with a urine strip (Arkray AUTION sticks 10EA). UTI was defined as colony count of ≥ 105 colony/ml from urine culture and leukocyte ≥ 250 cell/mm3. Prevalences of UTI during the past year and on the day of the study were reported. Univariate and multivariate analyses were performed to identify factors related with UTI.
Results: There were 78 subjects: 62 males with mean age of 42.8 years old (SD 13.6). Median and interquartile range of durations of CISC catheter were 96 and 104 months. Median and interquartile range of using current re-usable silicone catheter were 13 and 16 months. The prevalence of UTI during the past year was 19.2% and on the day of the study was 15.4%. According to the multivariate analysis, four factors were related with UTI: using collecting appliances for incontinence (OR=19.0; P=0.028), not retracting prepuce for cleaning urethral meatus (OR=20.4; P=0.040), not enough antiseptic solution in the tube (OR=53.2; P=0.029) and lack of self-confidence in performing CISC (OR=57.7; P=0.007).
Conclusion: The prevalence of UTI among SCI individuals using a reuse silicone catheter for CISC is less than 20%. Omittingsome steps that minimized bacteria increases the risk of UTI.
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