Urinary Tract Infections and Spinal Cord Injury

Urinary tract infections (UTIs) are considered to be the most prevalent bacterial infections with a significant economic burden on society (Grabe et al., 2012). UTIs are classified according to the localization of the infection, which includes the bladder (cystitis), kidney (pyelonephritis), or urine (bacteriuria), and can be asymptomatic or symptomatic (Foxman, 2002). Aguilar-Duran et al. (2012) report the classification of infections is according to the place of acquisition; hospital acquired (HA) infections that are detected 48 hours after hospital admissions and community acquired (CA) infections are those that do not meet the criteria to be in the first group as characteristically these infections are acquired from antibiotic-sensitive organisms that are uncomplicated to treat. According to the 1997 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, UTI within the United States results in approximately seven million medical office visits each year along with 1 million medical emergency visits, subsequently resulting in 100,000 hospitalizations (Schappert, 1997). In a study by Mazzulli (2002), nearly 15% of all prescribed antibiotics in the USA are distributed for UTIs at an estimated annual cost of over $1 billion. Additionally, the annual cost associated with community acquired UTIs in the United States exceeds an estimated $1.6 billion; this includes $474 million in medical expenses, $158 million in nonmedical expenses and $936 million in indirect cost or lost productivity (Foxman, 2000).