Skip to main content Accessibility help

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

  • Arjun Srinivasan (a1) (a2), Tobi Karchmer (a3), Ann Richards (a1), Xiaoyan Song (a1) and Trish M. Perl (a1) (a2)...



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


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.


Adult medical and surgical wards of a university teaching hospital.


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.


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.


Corresponding author

Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop A-35, Atlanta, GA30333 (


Hide All
1.Haley, RW, Culver, DH, White, JW, Morgan, WM, Emori, TG. The nationwide nosocomial infection rate: a new need for vital statistics. Am J Epidemiol 1985; 121:159167.
2.Tambyah, PA, Maki, DG. Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1497 catherized patients. Arch Intern Med 2000; 160:678682.
3.Platt, R, Polk, BF, Murdock, B, Rosner, B. Mortality associated with nosocomial urinary tract infection. N Engl J Med 1982; 307:637642.
4.Weinstein, MP, Towns, ML, Quarterly, SM, et al. The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology and outcome of bacteremia and fungemia in adults. Clin Infect Dis 1997; 24:584602.
5.Bryan, CS, Reynolds, KL. Hospital acquired bacteremic urinary tract infection: epidemiology and outcome. J Urol 1984; 132:494498.
6.Krieger, JN, Kaiser, DL, Wenzel, RP. Urinary tract etiology of bloodstream infections in hospitalized patients. J Infect Dis 1983; 148:5762.
7.Tambyah, PA, Knasinski, V, Maki, DG. The direct costs of nosocomial catheter associated urinary tract infection in the era of managed care. Infect Control Hosp Epidemiol 2002; 23:2731.
8.Classen, D. Assessing the effect of adverse hospital events on the cost of hospitalization and other patient outcomes [dissertation]. Salt Lake City: University of Utah; 1993.
9.Karchmer, TB, Gianetta, ET, Muto, CA, Strain, BA, Farr, BA. A randomized crossover study of silver coated urinary catheters in hospitalized patients. Arch Intern Med 2000; 160:32943298.
10.Jarlier, V, Fosse, T, Philippon, A. Antibiotic susceptibility in aerobic gram negative bacilli isolated in 39 French teaching hospitals. Intensive Care Med 1996; 22:10571065.
11.Schaberg, DR, Haley, RW, Highsmith, AK, Anderson, RL, McGowan, JE. Nosocomial bacteriuria: a prospective study of case clustering and antimicrobial resistance. Ann Intern Med 1980; 93:420424.
12.Naber, KG, Witte, W, Bauernfeind, A, et al. Clinical significance and spread of fluoroquinolone resistant uropathogens in hospitalized urologic patients. Infection 1994; 22:S122S127.
13.Paradisi, F, Corti, G, Mangani, V. Urosepsis in the critical care unit. Crit Care Clin 1998; 14:165180.
14.Vincent, JL, Bihari, DJ, Suter, PM, et al. The prevalence of nosocomial infection in intensive care units in Europe: results of the European Prevalence of Infection in Intensive Care (EPIC) study. EPIC International Advisory Committee. JAMA 1995; 274:639644.
15.Lai, KK, Fontecchio, SA. Use of silver-hydrogel urinary catheters on the incidence of catheter associated urinary tract infections in hospitalized patients. Am J Infect Control 2002; 30:221225.
16.Liedberg, H, Lundberg, T. Silver alloy coated catheters reduce catheter associated bacteriuria. Brit J Urol 1990; 65:379381.
17.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988; 16:128140 [published erratum appears in Am J Infect Control 1988; 16:177].
18.Miller, A, Linton, KB, Gillespie, WA, Slade, N, Mitchell, JP. Catheter drainage and infection in acute retention of urine. Lancet 1960; 1:310312.
19.Desautels, RE. Aseptic management of catheter drainage. N Engl J Med 1960; 263:189191.
20.Saint, S, Lipsky, BA. Preventing catheter related bacteriuria: Should we? Can we? How? Arch Intern Med 1999; 159:800808.
21.Johnson, JR, Delavari, P, Azar, M. Activities of a nitrofurazone containing urinary catheter and a silver hydrogel catheter against multidrug resistant bacteria characteristic of catheter associated urinary tract infection. Antimicrob Agents Chemother 1999; 43:29902995.
22.Dariouche, RO, Safar, H, Raad, II. In vitro efficacy of antimicrobial-coated bladder catheters in inhibiting bacterial migration along catheter surfaces. J Infect Dis 1997; 176:11091112.
23.Dariouche, RO, Smith, JA, Hanna, H, et al. Efficacy of antimicrobial impregnated bladder catheters in reducing catheter associated bacteriuria: a prospective, randomized, multicenter clinical trial. Urology 1999; 54: 976981.
24.Spadaro, JA, Berger, TJ, Barranco, SD, Chapin, SE, Becker, RO. Antibacterial effects of silver electrodes with weak direct current. Antimicrob Agents Chemother 1974; 6:637642.
25.Ahearn, DG, Grace, DT, Jennings, MJ, et al. Effects of hydrogel/silver coatings on in vitro adhesion to catheters of bacteria associated with urinary tract infections. Curr Microbiol 2000; 41:120125.
26.Riley, DK, Classen, DC, Stevens, LE, Burke, JP. A large randomized clinical trial of a silver impregnated urinary catheter: lack of efficacy and staphylococcal superinfection. Am J Med 1995; 98:349356.
27.Johnson, JR, Roberts, PL, Olsen, RJ, Moyer, KA, Stamm, WE. Prevention of catheter associated urinary tract infection with a silver-oxide coated urinary catheter: clinical and microbiologic correlates. J Infect Dis 1990; 162:11451150.
28.Liedberg, H, Lundberg, T, Ekman, P. Refinements in the coating of urethral catheters reduces the incidence of catheter associated bacteriuria. Eur Urol 1990; 17:236240.
29.Verleyen, P, De Ridder, D, Van Poppel, H. Clinical application of the Bardex IC Foley catheter. Eur Urol 1999; 36:240246.
30.Thibon, P, Le Coutour, X, Leroyer, R, Fabry, J. Randomized multi-centre trial of the effects of a catheter coated with hydrogel and silver salts on the incidence of hospital acquired urinary tract infections. J Hosp Infect 2000; 45:117124.
31.Saint, S, Elmore, JG, Sullivan, SD, Emerson, SS, Koepsell, TD. The efficacy of silver alloy coated urinary catheters in preventing urinary tract infection: a meta analysis. Am J Med 1998; 105:236241.
32.Saint, S, Veenstra, DL, Sullican, SS, Chenoweth, C, Fendrick, M. The potential clinical and economic benefits of silver alloy urinary catheters in preventing urinary tract infection. Arch Intern Med 2000; 160:26702675.
33.Turjanmaa, K, Alenius, H, Rennuala, T, Palosuo, T. Recent developments in latex allergy. Curr Opin Allergy Clin Immunol 2002; 2:407412.
34.Hepner, DL, Castells, MC. Latex allergy: an update. Anesth Analg 2003; 96:12191229.
35.Krieger, JN, Kaiser, DL, Wenzel, RP. Urinary tract etiology of bloodstream infections in hospitalized patients. J Infect Dis 1983; 148:5762.
36.Sheng, WH, Ko, WJ, Wang, JT, Chang, SC, Hsuch, PR, Luh, KT. Evaluation of antiseptic impregnated central venous catheters for prevention of catheter related infection in intensive care unit patients. Diagn Microbiol Infect Dis 2000; 38:15.
37.Walder, B, Pittet, D, Tramer, MR. Prevention of bloodstream infections with central venous catheters treated with anti-infective agents depends on catheter type and insertion time: evidence from a meta-analysis. Infect Control Hosp Epidemiol 2002; 23:748756.
38.Hartmann, M, Guttmann, J, Muller, B, Hallmann, T, Geiger, K. Reduction of the bacterial load by the silver coated endotracheal tube (SCET), a laboratory investigation. Technol Health Care 1999; 7:359370.

Related content

Powered by UNSILO

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

  • Arjun Srinivasan (a1) (a2), Tobi Karchmer (a3), Ann Richards (a1), Xiaoyan Song (a1) and Trish M. Perl (a1) (a2)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.