Infecciones de orina en pacientes sondados con patología neurológica. Estudio de las posibles causas / Urinary tract infections in patients with urinary catheterization who suffer neurological disorders. Study of the possible causes

RESUMEN

Por estudios realizados en nuestro hospital, se observó que todos los años existía una diferencia considerable entre las infecciones de orina en pacientes sondados del servicio de Neurología con respecto a otras unidades de hospitalización. Esto nos llevó a realizar el presente estudio. Objetivo. Determinar las causas que aumentan las infecciones del tracto urinario (ITU) en el paciente sondado con patología neurológica. Metodología. Estudio observacional descriptivo prospectivo de 50 pacientes con patología neurológica ingresados en la planta de Neurología del Hospital de Cabueñes (Gijón), que precisaron sondaje vesical (SV). El trabajo de campo consistió en recoger una muestra para sedimento y cultivo de orina pre y post-SV, además de anotar las causas del sondaje, duración, edad, sexo y diagnóstico en una hoja de registro. Se descartaron aquellos pacientes sondados de urgencias, los que estaban tomando antibiótico y aquellos cuya patología no era neurológica. Resultados. De 50 pacientes estudiados que precisaron SV, el 40 % fue por retención de orina, un 40 % por orden médica y el 20 % por tratamiento con manitol. El 88 % tuvo un diagnóstico de ictus. Un 12 % ya tenía el cultivo positivo antes de ser portadores de SV. Conclusiones. El ictus es la patología neurológica que más precisa SV. Una de las causas más importantes de aquel es la retención de orina. Algunos de los pacientes sondados ya tenían ITU antes de la colocación de SV (AU)

ABSTRACT

In previous studies carried out in our hospital (Hospital de Cabueñes, Gijón, Spain) it could be noticed/stated that every year there was a considerable difference between the patients with urine catheterization in the Neurology Service and the patients in the other hospital wards. This encourages us to carry out the following research. Objectives. The purpose of this study is to determine the causes that increase the urinary infections in neurological patients with bladder catheterization compared to catheterized patients with other diseases. Analysis of sediment and urine culture before and after the urinary bladder catheterization. Methods. Retrospective, descriptive and observational study of fifty patients with neurological disorders who were hospitalized in the neurological care unit of Hospital de Cabueñes (Gijón, Spain) and who needed urinary catheterization. The fieldwork consisted of collecting a sample for sediment and culture before and after the urinary catheterization and also of registering the causes of the catheterization, the length of the treatment, age and sex of patients on a medical record sheet. Patients who were catheterized in the Emergency (A&E) unit, those who were taking antibiotics and those who did not suffer a neurological disease did not take part in this study. Results. 20 patients (40 %) out of the 50 who took part in this study and who needed urinary catheterization (UC) suffered from urinary retention, another 20 (40 %) were under medical diagnosis and supervision and the last 10 (20 %) were treated with manitol. 44 patients (88 %) were diagnosed with strokes. 12 % of them had a positive culture prior to UC placement. Conclusions. Patients who suffered stokes have a high risk of urine retention due to their functional disability. Some of them had already the urine values altered, they even had infection prior to the urinary catheter placement (AU)