Common Pathogens and their Antimicrobial Susceptibility Pattern in Urinary Tract Infection Among Spinal Cord Injury Cohort

Objective: To determine the frequency of nosocomial urinary tract infections in patients admitted for spinal cord injury rehabilitation, identify the organisms responsible, and determine their susceptibility to systemic antimicrobials. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine, Rawalpindi Pakistan, from Sep 2022 to Apr 2023. Methodology: Samples for urine culture and sensitivity were taken from 47 individuals; 25 of these were excluded due to the growth of mixed organisms. Both male and female patients were included with Spinal Cord injury and admitted to the Inpatient Department for rehabilitation. Spinal cord injuries were classified as acute (<6 months) and chronic (>six months), depending upon the time elapsed since the injury. Symptoms of urinary tract infections were documented. Results: The sample showed a male preponderance, with 18(81.80%) males and 4(18.20%) females. Twelve individuals (54.5%) had symptoms of urinary tract infection. The urine sample yielded microbial growth in 19(86.40%) samples, confirming the diagnosis of UTI. Out of the participants, 9(40.90%) had acute SCI, while 13(59.10%) had chronic SCI. The mean duration since the SCI was 8.04±5.84 months. Conclusion: In patients with urinary tract infections associated with spinal cord injury, Klebsiella and Escherichia coli were found to be the major causative organisms. Meropenem, Fosfomycin, and Gentamicin were found to be the most effective initial choice of antibiotics, exhibiting increased sensitivity against the alleged microorganisms.