ArticleArchives of physical medicine and rehabilitation2018
Routine Urine Testing at the Spinal Cord Injury Annual Evaluation Leads to Unnecessary Antibiotic Use: A Pilot Study and Future Directions.
Article in Archives of physical medicine and rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Cranberry for Bacteriuria in Individuals with Spinal Cord Injury: A Systematic Review and Meta-Analysis.Oxidative medicine and cellular longevity · 2020Pooled it
- Test Smart, Treat Smart-using clinician feedback to adapt a catheter-associated urinary tract infection intervention for spinal cord injury.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Urological management in people with traumatic and non-traumatic spinal cord injury in Brazil.Scientific reports · 2025Article
- Development of a Risk Score to Aid With the Diagnosis of Infections After Spinal Cord Injury: Protocol for a Retrospective Cohort Study.JMIR research protocols · 2025Article
- Antibiotic prophylaxis with urodynamic studies in spinal cord injury: Assessing practice patterns and outcomes to guide future practice in a single center.The journal of spinal cord medicine · 2025Article
- Management of Asymptomatic Bacteriuria and Urinary Tract Infections in Patients With Neurogenic Bladder and Factors Associated With Inappropriate Diagnosis and Treatment.Archives of physical medicine and rehabilitation · 2024Article
- Impact of routine urine cultures on antibiotic usage in those undergoing a routine annual spinal cord injury evaluation.Spinal cord · 2023Article
- Indwelling catheter vs intermittent catheterization: is there a difference in UTI susceptibility?BMC infectious diseases · 2023Article
- Effect of an antimicrobial stewardship program in the prevention of antibiotic misuse in patients with spinal cord injury undergoing minor urologic procedures: a single-group, quasi-experiment study.BMC infectious diseases · 2023Article
- Urinary Symptoms Among People With Neurogenic Lower Urinary Tract Dysfunction (NLUTD) Vary by Bladder Management.Topics in spinal cord injury rehabilitation · 2023Article
- Clinical outcomes associated with guideline-discordant management of asymptomatic bacteriuria and urinary tract infection in hospitalized patients with neurogenic bladder.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- IntravesicalTopics in spinal cord injury rehabilitation · 2022Article
- Experiences of veterans with spinal cord injury related to annual urine screening and antibiotic use for urinary tract infections.PM & R : the journal of injury, function, and rehabilitation · 2021Article
- Antimicrobial stewardship in spinal cord injury: A multidisciplinary approach.The journal of spinal cord medicine · 2021Article
- The association between urine neutrophil gelatinase-associated lipocalin and UTI in people with neurogenic lower urinary tract dysfunction.Spinal cord · 2021Article
- Administration of indwelling urinary catheters in four Australian Hospitals: cost-effectiveness analysis of a multifaceted nurse-led intervention.BMC health services research · 2021Article
- Spinal Cord Injury Provider Knowledge and Attitudes Toward Bacteriuria Management and Antibiotic Stewardship.PM & R : the journal of injury, function, and rehabilitation · 2020Article
- Frequency of patient-reported UTIs is associated with poor quality of life after spinal cord injury: a prospective observational study.Spinal cord · 2020Observational
- Conception and development of Urinary Tract Infection indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project.The journal of spinal cord medicine · 2019Article
- Genitourinary Complications Are a Leading and Expensive Cause of Emergency Department and Inpatient Encounters for Persons With Spinal Cord Injury.Archives of physical medicine and rehabilitation · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo measure the prevalence of asymptomatic bacteriuria (ASB) in persons with spinal cord injury (SCI) at the time of their annual examination and to examine the effect on urine testing during the annual examination on subsequent antibiotic use.
designRetrospective cohort study.
settingA major SCI center.
participantsVeterans (N=393) with SCI seen for an outpatient annual evaluation in 2012 or 2013.
interventionsNot applicable.
main outcome measuresAntibiotic use for bacteriuria within 7 days of the annual evaluation encounter.
resultsThere were 327 clinic visits that met inclusion criteria; of these 327 veterans, 249 had a urine culture performed. A total of 171 urine cultures (69%) were positive for bacteria, of which 22 (13%) represented urinary tract infection (UTI) cases and 149 (87%) were ASB cases. More than a third of the ASB cases (n=53 [36%]) were treated with antibiotics. None of the 78 visits with negative urine cultures received antibiotics to treat the UTI; thus, a positive urine culture alone was associated with antibiotic use (P<.01). Factors predicting antibiotic use were higher age, nitrite presence on urinalysis, and urease-producing organism on culture media. When comparing bladder management strategies, indwelling catheterization was found to be associated with higher levels of pyuria and hematuria than did spontaneous voiding or intermittent catheterization (P<.01).
conclusionsTwo-thirds of the urine cultures of persons with SCI presenting for their annual examination were positive. Most of the positive cultures represented ASB cases, and more than a third of these were treated with antibiotics. A better understanding of the mandate for urine testing at the annual examination and the outcomes of this practice is an important first step in developing antibiotic stewardship for UTI in persons with SCI.
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Registered trials
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