# Optimizing Bacteriuria Management in Veterans with Spinal Cord Injury

> **NIH VA IK2** · MICHAEL E DEBAKEY VA MEDICAL CENTER · 2020 · —

## Abstract

Candidate: Dr. Felicia Skelton completed medical school at Baylor College of Medicine (BCM), residency in
rehabilitation medicine at the University of Washington, serving as chief resident, and clinical fellowship in
spinal cord injury (SCI) medicine at BCM. She is a current health services R&D (HSR&D) post-doctoral fellow
at the Center for Innovations in Quality, Effectiveness and Safety (IQuESt) at the Michael E. DeBakey VA
Medical Center (MEDVAMC) in Houston, TX. She has four first-authored publications, one submitted
manuscript and two pending manuscripts. She is dedicated to a career as a clinician scientist, and as a Black
female, an ideal candidate for the Historically Black College or University (HBCU) Research Scientist Training
Program. Career Development and Goals: During this award period Dr. Skelton will obtain the necessary
epidemiologic, qualitative methods, database analysis and implementation science skills to become an
independently-funded clinician scientist exploring optimal health care delivery and outcomes for Veterans with
SCI. This will be achieved through completion of coursework leading to a masters in clinical investigation from
BCM, as well as other targeted educational opportunities developed by her diverse group of mentors and
advisors. Environment: IQuESt and MEDVAMC are the ideal settings to complete this research, as the
premiere HSR center in the Southwest and the one of the largest SCI centers in the nation, serving over 450
Veterans in the outpatient setting annually, respectively. Dr. Skelton has the support of clinical, research,
administrative and patient advocacy leadership both locally and nationally for this project. Research:
Bacteriuria, ether asymptomatic (ASB) or symptomatic urinary tract infection (UTI) is common in persons SCI.
Current Veterans Health Administration (VHA) guidelines recommend a screening urine culture for every
Veteran with SCI during their annual evaluation, even when symptomatic, which is contrary to other national
guidelines. Our preliminary data suggest that a positive urine culture (even without signs or symptoms of
infection) drives antibiotic use. As the clinical outcomes of the annual exam testing have not been explored, we
theorize some Veterans are receiving antibiotics unnecessarily. The negative consequences of antibiotic
overuse and antibiotic resistance are well documented, and have a national and even global focus. This study
will develop an intervention aimed to educate stakeholders on evidence-based management of ASB and UTI,
and guide antibiotic stewardship in this high-risk population. Aim 1 will identify patient, provider, and facility
factors driving bacteriuria testing and subsequent antibiotic use after the SCI annual evaluation using
qualitative interviews and quantitative surveys. Aim 2 will use national VHA databases to identify the predictors
of urine testing and subsequent antibiotic use during the annual examination, and compare the clinical
outcomes of ...

## Key facts

- **NIH application ID:** 9873901
- **Project number:** 5IK2HX002484-03
- **Recipient organization:** MICHAEL E DEBAKEY VA MEDICAL CENTER
- **Principal Investigator:** Felicia Skelton
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-11-01 → 2022-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9873901

## Citation

> US National Institutes of Health, RePORTER application 9873901, Optimizing Bacteriuria Management in Veterans with Spinal Cord Injury (5IK2HX002484-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9873901. Licensed CC0.

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