{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T17:57:19Z","timestamp":1783965439534,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,4,13]],"date-time":"2017-04-13T00:00:00Z","timestamp":1492041600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>Patients suffering from spinal cord injuries resulting in complete or incomplete paraplegia or tetraplegia are highly disposed to frequent, recurrent or even chronic urinary tract infections (<jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>s). The reason for the increased risk of acquiring <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>s is multifactorial, including reduced sensation of classical <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> symptoms, incomplete bladder emptying, frequent catheterizations or chronic urinary tract catheters. Biofilms in relation to <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>s have been shown both on catheters, on concrements or as intracellular bacterial communities (<jats:styled-content style=\"fixed-case\">IBC<\/jats:styled-content>s). Due to the increased risk of acquiring recurrent or chronic <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>s and frequent antibiotic treatments, patients experience an increased risk of being infected with antibiotic\u2010resistant bacteria like extended\u2010spectrum \u03b2\u2010lactamase\u2013producing <jats:italic>Escherichia coli<\/jats:italic> or <jats:italic>Klebsiella<\/jats:italic> spp., but also bacteria like <jats:italic>Pseudomonas aeruginosa<\/jats:italic> inherently resistant to several antibiotics. Diagnosing the <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> can also be challenging, especially distinguishing harmless colonization from pathogenic infection. Based on a previous study showing activation of humoral immune response toward <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> pathogens in patients with spinal cord lesions (<jats:styled-content style=\"fixed-case\">SCL<\/jats:styled-content>), the present mini review is an evaluation of using antibody response as an indicator of chronic biofilm <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>. In addition, we evaluated the effect of long\u2010term treatment with antibiotics in patients with <jats:styled-content style=\"fixed-case\">SCL<\/jats:styled-content>s and chronic <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>, defined by culturing of a uropathogen in the urine and elevated specific precipitating antibodies against the same uropathogen in a blood sample. Elimination of chronic <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>, decrease in specific precipitating antibody values and avoiding selection of new multidrug\u2010resistant (<jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content>) uropathogens were the primary markers for effect of treatment. The results of this evaluation suggest that the long\u2010term treatment strategy in <jats:styled-content style=\"fixed-case\">SCL<\/jats:styled-content> patients with chronic <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> may be effective; however, randomized prospective results are needed to confirm this.<\/jats:p>","DOI":"10.1111\/apm.12685","type":"journal-article","created":{"date-parts":[[2017,4,16]],"date-time":"2017-04-16T13:52:27Z","timestamp":1492350747000},"page":"385-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Chronic urinary tract infections in patients with spinal cord lesions \u2013 biofilm infection with need for long\u2010term antibiotic treatment"],"prefix":"10.1111","volume":"125","author":[{"given":"Nete","family":"Tofte","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex C. 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