Changes in urine composition after trauma facilitate bacterial growth
1 Site Xavier Bichat, INSERM U722 and Université Paris 7 Denis Diderot, 16 rue Henri Huchard, Paris 75018, France
2 Hôpital de Bicêtre, Département d’Anesthésie Réanimation, Assistance Publique - Hôpitaux de Paris and Université Paris 11 Le Kremlin Bicêtre, Paris, France
3 Hôpital Cochin, Laboratoire de Biochimie, Assistance Publique - Hôpitaux de Paris and Université Paris 5, Paris, France
4 Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital de Bicêtre, Assistance Publique - Hôpitaux de Paris and Université Paris 11 Le Kremlin Bicêtre, Paris, France
5 Faculté de Médecine, Site Villemin, URC and Université Paris 7 Denis Diderot, Paris, France
BMC Infectious Diseases 2012, 12:330 doi:10.1186/1471-2334-12-330Published: 29 November 2012
Critically ill patients including trauma patients are at high risk of urinary tract infection (UTI). The composition of urine in trauma patients may be modified due to inflammation, systemic stress, rhabdomyolysis, life support treatment and/or urinary catheter insertion.
Prospective, single-centre, observational study conducted in patients with severe trauma and without a history of UTIs or recent antibiotic treatment. The 24-hour urine samples were collected on the first and the fifth days and the growth of Escherichia coli in urine from patients and healthy volunteers was compared. Biochemical and hormonal modifications in urine that could potentially influence bacterial growth were explored.
Growth of E. coli in urine from trauma patients was significantly higher on days 1 and 5 than in urine of healthy volunteers. Several significant modifications of urine composition could explain these findings. On days 1 and 5, trauma patients had an increase in glycosuria, in urine iron concentration, and in the concentrations of several amino acids compared to healthy volunteers. On day 1, the urinary osmotic pressure was significantly lower than for healthy volunteers.
We showed that urine of trauma patients facilitated growth of E. coli when compared to urine from healthy volunteers. This effect was present in the first 24 hours and until at least the fifth day after trauma. This phenomenon may be involved in the pathophysiology of UTIs in trauma patients. Further studies are required to define the exact causes of such modifications.