Urinary tract infection in the neurogenic bladder

Abstract: There is a high incidence of urinary tract infection (UTI) in patients with neurogenic lower
urinary tract function. This results in significant morbidity and health care utilization. Multiple wellestablished
risk factors unique to a neurogenic bladder (NB) exist while others require ongoing investigation.
It is important for care providers to have a good understanding of the different structural, physiological,
immunological and catheter-related risk factors so that they may be modified when possible. Diagnosis
remains complicated. Appropriate specimen collection is of paramount importance and a UTI cannot be
diagnosed based on urinalysis or clinical presentation alone. A culture result with a bacterial concentration
of ≥103 CFU/mL in combination with symptoms represents an acceptable definition for UTI diagnosis in
NB patients. Cystoscopy, ultrasound and urodynamics should be utilized for the evaluation of recurrent
infections in NB patients.