Analysis of the efficacy of fosfomycin trometamol in preventing biofilm bacterial infection in double-J stents among diabetic patients and the factors associated with infection.
Jun Bing Ye, Ke Zeng, Xiao Bin Li et al.
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In 30 seconds
This prospective randomized controlled trial compared fosfomycin trometamol (FMT) with levofloxacin (LFX) for preventing biofilm-forming bacterial colonization of double-J stents in 100 adults with diabetes. At stent removal, colonization was detected in 7/50 (14.0%) patients receiving FMT and 17/50 (34.0%) receiving LFX (χ² = 5.48, p = 0.019). Escherichia coli was the most common isolate, and several risk factors were independently associated with infection, including longer stent duration and higher HbA1c. The authors conclude that FMT was associated with lower colonization than LFX.
Key findings
- Biofilm-forming bacteria were detected in 7/50 (14.0%) FMT recipients versus 17/50 (34.0%) LFX recipients (p = 0.019).
- Escherichia coli accounted for 50% of positive cultures; 83.3% (10/12) of these isolates produced extended-spectrum β-lactamases.
- Age ≥ 60 years, stent duration ≥ 30 days, fluid intake ≤ 2000 mL/day, albumin < 30 g/L, creatinine > 110 μmol/L, and HbA1c > 6% were independent risk factors.
Why it matters
Stent-associated bacterial colonization was common in this diabetic cohort, and the isolates showed substantial resistance to several tested antibiotics. The lower colonization rate with FMT than with LFX offers comparative evidence relevant to prophylaxis in this population, while the identified risk factors highlight clinical and device-related characteristics associated with infection. These findings also underscore the importance of considering local susceptibility patterns.
What to keep in mind
The study was conducted at a single tertiary care center and assessed bacterial colonization on stent specimens at removal; the abstract does not report clinical infection outcomes.