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Amaral DM, Pereira AMVC, Rodrigues MR, et al. Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis. Porto Biomed J. 2019;4(6):e56doi: 10.1097/j.pbj.0000000000000056.
Amaral, D. M., Pereira, A. M. V. C., Rodrigues, M. R., Gandarez, M. F. L., Cunha, M. R., & Torres, M. S. R. (2019). Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis. Porto biomedical journal, 4(6), e56. https://doi.org/10.1097/j.pbj.0000000000000056
Amaral, Daniela M, et al. "Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis." Porto biomedical journal vol. 4,6 (2019): e56. doi: https://doi.org/10.1097/j.pbj.0000000000000056
Amaral DM, Pereira AMVC, Rodrigues MR, Gandarez MFL, Cunha MR, Torres MSR. Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis. Porto Biomed J. 2019 Nov 26;4(6):e56. doi: 10.1097/j.pbj.0000000000000056. eCollection 2019. PMID: 33501398; PMCID: PMC7819542.
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Porto Biomed J. 2019 Nov 26;4(6):e56. doi: 10.1097/j.pbj.0000000000000056. eCollection 2019.

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

Porto biomedical journal

Daniela M Amaral, Ana Margarida V C Pereira, Margarida R Rodrigues, Maria de Fátima L Gandarez, Maria R Cunha, Marta S R Torres

Affiliations

  1. Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de São João, Porto.
  2. Centro de Reabilitação do Norte, Valadares, Portugal.

PMID: 33501398 PMCID: PMC7819542 DOI: 10.1097/j.pbj.0000000000000056

Abstract

BACKGROUND: Urinary tract infection (UTI) is a common complication of spinal cord injury (SCI). Urodynamic testing is widely used for characterization of vesico-sphincteric dysfunction and for therapeutic orientation. As an invasive procedure, the risk of UTI is increased so, in some medical centers, antibiotic prophylaxis is instituted. Fosfomycin is one of the antibiotics used.

OBJECTIVE: The aim of this study was to evaluate the incidence of UTI after urodynamics in patients with SCI, under fosfomycin prophylaxis.

METHODS: Retrospective analysis was performed on patients with SCI, admitted to a rehabilitation center between January 2016 and June 2017, who underwent urodynamics studies under fosfomycin prophylaxis. Demographic data, risk factors for UTI-bacteriuria before urodynamics, high residual volume (>100 mL), bladder emptying method, vesico-sphincteric dyssynergia, and detrusor hyperactivity were analyzed. The incidence of UTI after urodynamics was evaluated.

RESULTS: The study included 84 patients, predominantly men 55 (65.5%). The mean age of the patients was 55.6 (18.9). Eleven (22.5%) had vesico-sphincteric dyssynergia, 32 (65.3%) detrusor hyperactivity and 22 (44.9%) had a high residual volume. Thirty-seven (44.1%) had asymptomatic bacteriuria before the urodynamics. Urinary complaints suggestive of UTI after urodynamics were observed in 2(2.4%) of patients, without significant bacteriuria and identification of bacterial agent.

CONCLUSIONS: The incidence of UTI after invasive procedures is reported between 3% and 20% in the literature, so antibiotic prophylaxis has been instituted, although controversial. In the study, in none of the patients the diagnosis of UTI was confirmed. Fosfomycin prophylaxis may have been important in reducing the incidence of UTI.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of PBJ-Associação Porto Biomedical/Porto Biomedical Society. All rights reserved.

Keywords: antibiotic prophylaxis; urinary tract infection; urodynamic study

Conflict of interest statement

The authors declare no conflicts of interest.

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