Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Porto Biomed. J., 2019 · DOI: http://dx.doi.org/10.1097/j.pbj.0000000000000056 · Published: November 7, 2019

Simple Explanation

This study investigates the effectiveness of fosfomycin prophylaxis in preventing urinary tract infections (UTIs) after urodynamic studies (UDS) in patients with spinal cord injury (SCI). UTIs are a common complication in SCI patients, and UDS, while important for diagnosis, can increase the risk of infection. The study retrospectively analyzed data from 84 SCI patients who underwent UDS with fosfomycin prophylaxis. Researchers looked at various risk factors for UTIs, such as pre-existing bacteriuria and bladder dysfunction. The results showed a very low incidence of UTI in the studied population. The researchers suggest that fosfomycin prophylaxis might have contributed to this low incidence, but further research is needed.

Study Duration

January 2016 and June 2017

Participants

84 patients with SCI

Evidence Level

Retrospective cohort study

Key Findings

1
The incidence of UTI, as defined by NIDRR criteria, was 0% in the study population following urodynamic studies with fosfomycin prophylaxis.
2
Urinary complaints suggestive of UTI after UDS were observed in 2.4% of patients, but none had significant bacteriuria, leukocyturia, or bacterial agent identification.
3
Nearly half the patients (44.1%) had asymptomatic bacteriuria before the urodynamics, with Escherichia coli being the most frequently isolated microorganism.

Research Summary

This retrospective study evaluated the incidence of UTI after urodynamics in patients with SCI, under fosfomycin prophylaxis, finding a 0% incidence of UTI according to NIDRR criteria. The study included 84 patients and analyzed various risk factors for UTI, observing that a significant percentage of patients had asymptomatic bacteriuria before the procedure. The authors conclude that fosfomycin prophylaxis may have been important in limiting the occurrence of UTI, but further randomized controlled trials are needed to confirm these findings and optimize antibiotic prophylaxis strategies.

Practical Implications

Infection Prevention

Fosfomycin prophylaxis may be a useful strategy for preventing UTIs after urodynamic studies in SCI patients.

Further Research Needed

Randomized controlled trials are necessary to determine the optimal antibiotic prophylaxis regimen for SCI patients undergoing UDS.

Clinical Practice

Clinicians should consider the potential benefits of fosfomycin prophylaxis in reducing UTI risk in this patient population.

Study Limitations

1
Retrospective cohort study design.
2
Small number of participants.
3
Heterogeneity of the characteristics of the studied population regarding the age, type, and duration of SCI

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