**8. Skin colonization**

As mentioned, bacterial colonization of the skin and the urethra is an important source of bladder infection using catheters. Differences in microbial species and their presence in normal skin flora of SCI patients and other neurogenic urinary disorders in relation to individuals without neurogenic disorders may result from the use of antibiotic therapy, use of condom catheters, pH and skin temperature in the area, personal hygiene, or fecal contamination. Pseudomonas colonizes the perineum, in addition to the high pH of the skin of the area appears to contribute positively to the high risk of colonization [78, 79]. The meticulous soap wash of the perineum area only has temporary effects in reducing its colonization by Gram-negative microorganisms, whereas the use of antiseptics, such as chlorhexidine and povidone-iodine, has no effect [80, 81].
