Traczuk Ashley E, Stillman Michael
Medicine, Thomas Jefferson University Hospital, Philadelphia, USA.
Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, USA.
Cureus. 2025 Jul 28;17(7):e88907. doi: 10.7759/cureus.88907. eCollection 2025 Jul.
Individuals with spinal cord injury (SCI) and neurogenic bladder often rely on catheterization programs, which increase the risk of urinary tract infections (UTIs). Sodium-glucose cotransporter-2 inhibitors (SGLT2i), widely used in the management of diabetes mellitus (DM), chronic kidney disease (CKD), and congestive heart failure (CHF), promote urinary glucose excretion, potentially fostering an environment favorable to bacterial and fungal growth. This case describes a 53-year-old man with long-standing traumatic cervical SCI and a suprapubic catheter who presented with sepsis secondary to fungemia, in the context of SGLT2i use for DM management. This report suggests that the combination of SGLT2i therapy and chronic catheterization may increase the risk of urinary tract and invasive fungal infections. While current evidence is lacking, further investigation is warranted, and clinicians should exercise caution when prescribing SGLT2i in patients with SCI and bladder catheter use.
脊髓损伤（SCI）和神经源性膀胱患者通常依赖导尿方案，这会增加尿路感染（UTIs）的风险。钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）广泛用于糖尿病（DM）、慢性肾脏病（CKD）和充血性心力衰竭（CHF）的管理，可促进尿糖排泄，可能会营造有利于细菌和真菌生长的环境。本病例描述了一名53岁男性，患有长期创伤性颈髓损伤且使用耻骨上导尿管，在使用SGLT2i治疗糖尿病的情况下，因真菌血症继发脓毒症。本报告提示，SGLT2i治疗与长期导尿相结合可能会增加尿路和侵袭性真菌感染的风险。鉴于目前缺乏证据，有必要进一步研究，临床医生在为脊髓损伤且使用膀胱导尿管的患者开具SGLT2i时应谨慎行事。
