A study this spring about the relationship between pressure injuries and urinary tract infections (UTIs) in patients with spinal cord injury (SCI) underlines the need for close monitoring for infections.
The study — Microbial and inflammatory profiling of pressure injuries and urinary tract infections in spinal cord injury: a prospective cohort study — was published by Scientific Reports in March.
Investigators looked at patients with SCI who’d undergone surgeries related to pressure injuries — and then examined the likelihood of UTIs developing in those patients. Authors noted that other research had “reported that patients with a history of pressure injuries had a significantly higher risk of developing postoperative infections than those without such a history.”
“The role of pressure injuries in the development of postoperative UTIs remains unclear,” the research’s abstract noted. “In this exploratory study, we investigated the relationship between the pressure injury microbiome and urinary bacteria, and examined whether perioperative bacteriuria predicts prolonged hospital stay in patients undergoing reconstructive pressure injury surgery.”
Researchers studied 21 male patients who had both SCI and “advanced-stage pressure injuries undergoing reconstructive surgery.”
The study’s authors analyzed patients’ urinary cytokine profiles — proteins that can indicate infection or stress in the urinary tract — as well as microbiome profiles at two key times: three days and 15 days after surgery. Patients had completed antibiotic courses by day 15.
“Asymptomatic bacteriuria was present in 48% of patients on day 3 and 38% on day 15,” authors said. “High bacterial load (≥ 100,000 bacteria/mL) in urine on day 3 correlated with increased UTI incidence and frequency, although hospitalization duration was unaffected. By day 15, urinary bacterial load was no longer associated with UTI incidence.
“Early perioperative high bacterial load is associated with increased urinary inflammation and a higher risk of postoperative UTIs in patients with SCI undergoing PI reconstruction. These findings support early infection monitoring and targeted preventive strategies to improve postoperative outcomes.”
UTIs “are among the most frequent complications” for patients living with SCI, with their high prevalence “largely attributable to the neurogenic lower urinary tract dysfunction, and the widespread use of intermittent or indwelling urinary catheters.”
