Infections Related to Traumatic Spinal Cord Injury

(Preliminary Data)

Kaeli Day, BS, Sangita Dash, MD, Kamla Sanasi MD

The National Spinal Cord Injury Statistical Center estimates 249,000-363,000 are living with spinal cord injury (SCI). SCI increases an individual’s risk of developing an infection due to anatomic changes and an increase in indwelling devices and hardware, with urinary tract infections (UTI) being the most prevalent. Traumatic spinal cord injury (TSCI) is any spinal cord injury not due to medical causes. 
This retrospective medical record review aims to describe infections related to patients with TSCI at a major healthcare system in the southeast. Charts were selected using ICD-9 codes corresponding to TSCI who were discharged from 8/1/10 through 8/31/15. Demographics, comorbid conditions, types of infections, and the antibiotic information was extracted. 
30 patients met the inclusion criteria. There were 148 admissions documented for 30 patients, 60% (n=89) were infection related. UTI accounted for the largest number of admissions (n=50, 31%) followed by skin/soft tissue infections (SSTI) (n= 49, 30%). There were 6 C. difficile admissions. This was preceded by the use of multiple antibiotics in 2 cases.
Bacteremia accounted for 9% (n= 14) admissions and osteomyelitis were in 9% (n=6). 
The most common organism isolated from blood cultures was SA, n=3 (21%) followed by Enterobacteracae n=2 (14%). 29% of these occurred in the presence of a central line. 
The most common UTI causing organisms were Enterobacteriaceae (n=46,92%). All of these were associated with an indwelling Foley catheter.

The two most frequent infections in patients with TSCI were UTI and SSTI. This is in keeping with the data in the literature.  This data is preliminary and may not be representative of this population.