Antibiotic Susceptibility Pattern of Organisms Causing Urinary Tract Infection in Spinal Cord Injured Patients with E test

Background: Urinary tract infection and resistant organisms are the most serious problems for
hospitalization and mortality in spinal cord injured patients. Empirical administration of various antibiotics
in hospitals has caused increased resistant organisms involved in UTI in these patients. In this study, the
antibiotic sensitivity of organisms isolated from urine samples of spinal cord injured patients with UTI was
investigated.
Materials and methods: It was a cross sectional study which was done on 145 male patients with spinal
cord injury and UTI referring to Al-Zahra hospital, Isfahan, from 1384 to 1385. Urine sample was obtained
from them on the basis of bladder drainage method (catheter, condom bag or cred maneuver) and was sent
for analysis and culture. MIC of various antibiotics on organisms was determined using E test.
Results: Mean age of patients was 44/1±2.According to culture results of patient´s urine samples,
Ecoli(53.3%), klebsiella(20%), Enterococcus(9.1%), pseudomonas aeroginosa(8.3%), proteus(0.8%),
serratia(2.5%),staphylococcus aureus (4.1%) and staphylococcus epidermidis(1.6%) were isolated. Highest
rate of positive cultures were seen in patients with permanent catheter.
The most percentage of sensitivity of organisms to antibiotics amikacin, ciprofloxacin, gentamicin,
trimethoprim/sulfamethoxazol, ceftriaxone and ceftazidim was respectively: in Ecoli %94.1 and Klebciella
100%to Amikacin, in pseudomonas 80% to Amikacin and Ceftazidim, in Enterococcus, Staphylococcus
aureus and epidermidis 80% to Vancomycin. The sensitivity of Proteus and Seratia to Ciprofloxacin,
Ceftriaxone, Ceftazidim and Amikacin was100%.Sensitivity of gram negative organims to Ciprofloxacin was
more than Ceftriaxone and sensitivity of all of them to Imipenem was 100%. The most resistancy of gram
negative organisms was to Trimethoprim/Sulfametoxazol and about Enterococcus and Staphylococcus was
to Amikacin.
Discussion: With regard to increased risk of urinary tract infection with resistant organisms in spinal
cord injury, determination of antibiotic sensitivity has an important role in proper treatment of these patients
and prevention of inadvertent use of broad spectrum antibiotics with unknown effect on organisms causing
urinary tract infection. Consequently it is useful in prevention of increasing microbial resistance and in
reduction of patient's costs.