Background: The definitions of urinary tract infections (UTI) and asymptomatic bacteriuria (ABU) are problematic to apply in patients with neurogenic bladder (NB). Here, we carried out a comparative analysis of the main clinical and laboratory data of NB patients with UTI and ABU.
Methods: One hundred ninety five patients with neurogenic bladder were evaluated in the Urology Sector at a neurorehabilitation hospital. Patients were divided into either ABU or UTI group based on clinical and laboratory data. The sociodemographic data, clinical history, and laboratory test results were collected and used in the comparative analysis.
Results: Of the patients evaluated, 161 (82.6%) had ABU. Patients of different age groups were affected, predominantly young adults (20-39 years). The median time of bladder involvement was 8.9 years (0-35). Neurogenic bowel was observed in 97.5% of cases and renal lithiasis in 11.3%. The main underlying pathologies leading to urologic involvement were spinal cord injury, myelomeningocele, stroke, and neoplasms. Only 16.4% of patients were not on intermittent catheterization, in which the risk of recurrent infection was higher than in patients who were under for intermittent bladder catheterization (p = 0.016, OR 2.65). Infection rates were significantly different between patients with histories of recurrent urinary tract infections (asymptomatic bacteriuria 29.8% vs 52.9% infection, p = 0.016). Leukocyturia was frequent in both groups, however, our data suggested that only values ≤ 30 cells/high power field excluded infection.
Conclusions: In summary, intermittent catheterization was observed to be essential in the prevention of recurrent UTI, as well as the need to adjust the reference values for leukocyturia in the definition of the infectious condition.