Systematic review of risk factors for urinary tract infection in adults with spinal cord dysfunction

Paul G. Shekelle, Sally C. Morton, Kenneth A. Clark, Mayank Pathak, Barbara G. Vickrey

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


Recurrent urinary tract infections (UTIs) occur frequently in persons with neurogenic bladders due to spinal cord dysfunction, resulting in increased morbidity and cost. The authors conducted a systematic review to identify risk factors for UTI using controlled clinical trials, cohort, and cross-sectional studies that assessed risk factors for UTI and included bacteriuria or UTI as an outcome. Twenty-two studies met the inclusion criteria. Quality assessment revealed important methodological deficiencies. Two studies provide evidence supporting increased bladder residual volume as a risk factor. Most of the retrieved studies investigated method of drainage with the consistent finding that persons using intermittent catheterization had fewer infections than those with indwelling catheters. There is conflicting evidence over the value of sterile or "no touch" catheter techniques compared with clean intermittent catheterization. There is insufficient evidence to assess risk due to psychosocial, behavioral, and hygiene factors; sex; level of function; and time since injury.

Original languageEnglish (US)
Pages (from-to)258-272
Number of pages15
JournalJournal of Spinal Cord Medicine
Issue number4
StatePublished - 1999
Externally publishedYes


  • Paraplegia
  • Risk factors
  • Systematic review
  • Urinary tract infection

ASJC Scopus subject areas

  • Clinical Neurology


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