ArticleArchives of physical medicine and rehabilitation2024
Management of Asymptomatic Bacteriuria and Urinary Tract Infections in Patients With Neurogenic Bladder and Factors Associated With Inappropriate Diagnosis and Treatment.
Article in Archives of physical medicine and rehabilitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- A survey of knowledge, experiences, and quality of life impacts related to urinary tract infections among people with neurogenic bladder.The journal of spinal cord medicine · 2026Article
- Diagnostic evaluation and treatment of UTIs in children with neurogenic bladder.Journal of pediatric urology · 2026Article
- The clinical complication scale of Fondazione Don Gnocchi for classifying clinical complications in patients with severe acquired brain injury: development and multicenter validation.Frontiers in neurology · 2025Article
- SCI Model Systems Complicated Urinary Tract Infection (cUTI) Guidelines: International Consensus on cUTI Likelihood Based on Symptoms.Topics in spinal cord injury rehabilitation · 2025Article
- Exploring urinary microbiome: insights into neurogenic bladder and improving management of urinary tract infections.Frontiers in cellular and infection microbiology · 2025Review
- Urinary Tract Infection Diagnosis Among People With Neurogenic Lower Urinary Tract Infection Due to Spinal Cord Injury and Disease: Time for a Change.Topics in spinal cord injury rehabilitation · 2025Review
- Urinalysis Abnormalities and Culture Positivity in Children With Clean Intermittent Catheterization.Pediatrics international : official journal of the Japan Pediatric SocietyArticle
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Authors and funding
8 authors at 7 institutions in 1 country.
Funding
Abstract
objectiveInappropriate diagnosis and treatment of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) are leading causes of antibiotic overuse but have not been well-studied in patients with risks for complicated UTI such as neurogenic bladder (NB). Our aim was to describe ASB and UTI management in patients with NB and assess factors associated with inappropriate management.
designRetrospective cohort study.
settingFour Department of Veteran's Affairs (VA) medical centers.
participantsAdults with NB due to spinal cord injury/disorder (SCI/D), multiple sclerosis (MS), or Parkinson disease (PD) and encounters with an ASB or UTI diagnosis between 2017 and 2018. Clinical and encounter data were extracted from the VA Corporate Data Warehouse and medical record reviews for a stratified sample of 300 encounters from N=291 patients.
interventionsNone.
main outcome measuresPrevalence of appropriate and inappropriate ASB and UTI diagnosis and treatment was summarized. Multivariable logistic regression models assessed factors associated with inappropriate management.
resultsN=200 UTI and N=100 ASB encounters were included for the 291 unique patients (SCI/D, 39.9%; MS, 36.4%; PD, 23.7%). Most patients were men (83.3%), >65 years (62%), and used indwelling or intermittent catheterization (68.3%). Nearly all ASB encounters had appropriate diagnosis (98%). 70 (35%) UTI encounters had inappropriate diagnosis, including 55 (27.5%) with true ASB, all with inappropriate treatment. Among the remaining 145 UTI encounters, 54 (27%) had inappropriate treatment. Peripheral vascular disease, chronic kidney disease, and cerebrovascular disease were associated with increased odds of inappropriate management; indwelling catheter (aOR 0.35, P=.01) and Physical Medicine & Rehabilitation provider (aOR 0.29, P<.01) were associated with decreased odds.
conclusionUp to half of UTI encounters for patients with NB had inappropriate management, largely due to inappropriate UTI diagnosis in patients with true ASB. Interventions to improve ASB and UTI management in patients with NB should target complex patients with comorbidities being seen by non-rehabilitation providers.
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