背景:视频尿动力学研究(VUDS)是客观评估脊髓损伤/疾病(SCI/D)患者神经源性下尿路功能障碍(NLUTD)的推荐诊断标准。这种检查需要将导管插入膀胱,这增加了尿路感染(UTI)的风险。VUDS后有症状的UTI数据有限。
方法:单中心,我们进行了观察性研究,以评估VUDS后7天患者报告的UTI体征和症状的发生率.未给予围介入抗生素。性的影响,年龄,SCI/D持续时间,膀胱排空方法,菌尿,UTI预防,UTI历史记录,使用二元逻辑回归分析检查VUDS后患者报告的UTI体征或症状的发生或不利的VUDS结果。
结果:共评估了140名患者,平均年龄为59.1±14.0岁,SCI/D病程中位数为15.0年(6/29年)。VUDS后7天(平均7±1天),42(30%)个人报告至少一种UTI体征或症状。在大多数情况下,症状和体征在不需要抗生素治疗的情况下得到解决,7名参与者(5%)需要这样做。男性(p=0.04)显着增加了VUDS后出现UTI体征和症状的几率(优势比3.74)。
结论:在NUTD患者中,30%的人在VUDS后1周出现UTI体征和症状。然而,这些体征和症状是短暂的,只有5%需要抗生素治疗.因此,似乎并非所有接受VUDS的SCI/D患者都需要抗生素预防.
BACKGROUND: Video-urodynamic studies (VUDS) are the recommended standard of diagnostic care to objectively assess neurogenic lower urinary tract dysfunction (NLUTD) in individuals with spinal cord injury/disease (SCI/D). This examination requires the insertion of a catheter into the bladder, which increases the risk of a urinary tract infection (UTI). Data on symptomatic UTIs after VUDS are limited.
METHODS: A single-center, observational study was conducted to evaluate the incidence of patient-reported UTI signs and symptoms 7 days after VUDS. No peri-interventional antibiotics were administered. The effect of sex, age, SCI/D duration, bladder evacuation method, bacteriuria, UTI prophylaxis, UTI history, or unfavorable VUDS results on the occurrence of patient-reported UTI signs or symptoms after VUDS was examined using binary logistic regression analysis.
RESULTS: A total of 140 individuals with a mean age of 59.1 ± 14.0 years and a median SCI/D duration of 15.0 years (6/29 years) were evaluated. Seven days (mean 7 ± 1 days) after VUDS, 42 (30%) individuals reported at least one UTI sign or symptom. In the majority, signs and symptoms resolved without the need for antibiotic treatment, which was required in seven participants (5%). Male sex significantly (p = 0.04) increased the odds (odds ratio 3.74) of experiencing UTI signs and symptoms after VUDS.
CONCLUSIONS: In individuals with NLUTD, 30% experienced UTI signs and symptoms 1 week after VUDS. However, these signs and symptoms were transient and only 5% required antibiotic treatment. Thus, antibiotic prophylaxis does not seem necessary in all individuals with SCI/D undergoing VUDS.