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A Prospective Trial of a Novel, Silicone-Based, Silver-Coated Foley Catheter for the Prevention of Nosocomial Urinary Tract Infections

Published online by Cambridge University Press:  21 June 2016

Arjun Srinivasan*
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
Tobi Karchmer
Affiliation:
Department of Medicine, Section of Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, North Carolina
Ann Richards
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland
Xiaoyan Song
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland
Trish M. Perl
Affiliation:
Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, Maryland Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop A-35, Atlanta, GA30333 (asrinivasan@cdc.gov)

Abstract

Objective.

To evaluate the efficacy of silicone-based, silver ion–impregnated urinary catheters in the prevention of nosocomial urinary tract infections (NUTIs).

Design.

Prospective, crossover study to compare the efficacy of a silicone-based, hydrogel-coated, silver-impregnated Foley catheter with that of a silicone-based, hydrogel-coated catheter in the prevention of NUTIs.

Setting.

Adult medical and surgical wards of a university teaching hospital.

Results.

A total of 3,036 patients with catheters were evaluated; 1,165 (38%) of the catheters were silver impregnated, and 1,871 (62%) were not silver impregnated. Study groups were not identical; there were more men, a shorter duration of catheterization, and fewer urine cultures per 1,000 catheter-days in the silver catheter group. The rate of NUTIs per 1,000 Foley-days was 14.29 in the silver catheter group, compared with 16.15 in the nonsilver catheter group (incidence rate ratio, 0.88; 95% confidence interval, 0.70-1.11; P = .29). The median length of catheterization prior to the onset of a urinary tract infection (ie, exposure time) was 4 days for each group. There were no differences in the recovery of gram-positive, gram-negative, or fungal organisms in NUTIs. In a multivariate survival analysis, no factors, including silver catheters, were protective against NUTI.

Conclusions.

Unlike previous trials of latex-based, silver ion–impregnated Foley catheters, we found that silicone-based, silver-impregnated Foley catheters were not effective in preventing NUTIs; however, this study was affected by differences in the study groups. Prospective trials remain important in assessing the efficacy and cost-effectiveness of new silver-coated products.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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A Prospective Trial of a Novel, Silicone-Based, Silver-Coated Foley Catheter for the Prevention of Nosocomial Urinary Tract Infections
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