Bladder irrigation with  Chlorhexidine reduces bacteriuria in persons with spinal cord injury

Wikström, Madeleine; Levi, Richard; Antepohl, Wolfram

doi:10.2340/16501977-2298

Cited by 13 publications

(14 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The urine samples were taken for the first urine culture three hours after irrigation. The results showed that irrigating the bladder with chlorhexidine alternately decreased bacteriuria in the majority of the patients with spinal cord injury (39).…”

Section: Discussionmentioning

confidence: 96%

“…The findings showed that preventing the colonization of hospitalized patients in ICUs with chlorhexidine baths once a day along with mupirocin could be a potential preventive strategy for male patients, as it significantly decreased candiduria and bacteriuria (38). Also, Wikstrom et al (39) aimed to assess the effect of bladder irrigation with chlorhexidine on reducing the incidence of bacteriuria in patients with spinal cord injury. They investigated 50 patients from two populations of hospitalized patients and patients living at home by random sampling from four rehabilitation centers in Sudan.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

et al. 2020

View full text Add to dashboard Cite

Background: Urinary tract infection is the most common site of infection associated with health care in the Intensive Care Unit (ICU) patients. Long-term catheterization is the most important risk factor for Urinary Tract Infections (UTIs). These infections are more common in women than in men. Colonized microorganisms in the perineal skin and around the urethra may move into the urinary system through the external surfaces of the urinary catheter to cause infection. Objectives: The present study aimed to compare the effect of perineal care with normal saline and 2% chlorhexidine solution on the rate of catheter-associated urinary tract infection (CAUTI) in women hospitalized in ICUs. Methods: A quasi-experimental study was performed on 70 female patients hospitalized in the ICU of Khatam-Al-Anbia Hospital of Zahedan in 2019. The research units meeting the inclusion criteria were selected using convenience sampling and then randomly divided into two groups of normal saline (n = 35) and chlorhexidine (n = 35). The perineal area of patients in the first group was washed with normal saline and the second group with 2% chlorhexidine solutions twice a day for seven days in both groups. To diagnose UTIs, urine samples were cultured on the first and seventh days. Data were analyzed using SPSS 21 via the independent t-test, chi-square test, and Fisher’s exact test at a significance level of less than 0.05. Results: Finally, 60 participants completed the study. The two groups did not differ significantly in terms of age, marital status, level of education, cause of hospitalization, antibiotic use, underlying diseases, fluid intake, and urinary output. At the end of the seventh day after the intervention, the incidence of UTIs was significantly lower in the chlorhexidine group (13.3%) than in the normal saline group (76.7%) (P = 0.001). Conclusions: The results showed that washing the perineal area every 12 hours with 2% chlorhexidine solution compared to normal saline reduces the incidence of CAUTIs in women hospitalized in ICUs. Therefore, perineal care with a 2% chlorhexidine solution is recommended for perineal care of female patients with urinary catheters hospitalized in ICUs.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Other interventions have been proposed for minimizing both extraluminal and intraluminal colonization pathways with conflicting reports and guidance for effectiveness in preventing CAUTI. e effectiveness of antimicrobial irrigation of the bladder followed by drainage had been contested in CDC guidelines [20] but more recently reported effective elsewhere [21,22]. Effectiveness of antimicrobial catheter coatings has similarly been reported to be inconclusive [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Pilot Ex Vivo and In Vitro Evaluation of a Novel Foley Catheter with Antimicrobial Periurethral Irrigation for Prevention of Extraluminal Biofilm Colonization Leading to Catheter-Associated Urinary Tract Infections (CAUTIs)

Vargas-Cruz

Rosenblatt

Reitzel

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

CAUTI remains a serious healthcare issue for incontinent patients whose urine drainage is managed by catheters. A novel double-balloon Foley catheter was developed which was capable of irrigating the extraluminal catheter surfaces within the periurethral space between the urethral-bladder junction and meatus. The catheter has a retention cuff that is inflated to secure the catheter in the bladder and a novel irrigation cuff proximal to the urethral-bladder junction capable of providing periurethral irrigation from the urethral-bladder junction to the meatus. Uniform periurethral irrigation was demonstrated in an ex vivo porcine model by adding a dye to the antimicrobial urethral irrigation solution. An in vitro biofilm colonization model was adapted to study the ability of periurethral irrigation with a newly developed antimicrobial combination consisting of polygalacturonic acid + caprylic acid (PG + CAP) to prevent axial colonization of the extraluminal urethral indwelling catheter shaft by common uropathogens. The extraluminal surface of control catheters that were not irrigated formed biofilms along the entire axial urethral tract after 24 hours. Significant (p<0.001) inhibition of colonization was seen against multidrug-resistant Pseudomonas aeruginosa (PA), carbapenem-resistant Escherichia coli (EC), and carbapenem-resistant Klebsiella pneumoniae (KB). For other common uropathogens including Candida albicans (CA), Proteus mirabilis (PR), and Enterococcus faecalis (EF), a first irrigation treatment completely inhibited colonization of half of the indwelling catheter closest to the bladder and a second treatment largely disinfected the remaining intraurethral portion of the catheter towards the meatus. The novel Foley catheter and PG + CAP antimicrobial irrigant prevented biofilm colonization in an in vitro CAUTI model and merits further testing in an in vivo CAUTI prevention model.

show abstract

“…Within this pilot study, it could be demonstrated that intravesical instillations with oxybutynin hydrochloride did not affect routine tests for a total of 25 model substances, and the method of bladder instillation as such does not appear to require specific attention in the context of doping control procedures. However, future studies should clarify whether this also applies to bladder irrigation procedures with antiseptics such as chlorhexidine …”

Section: Discussionmentioning

confidence: 99%

“…However, future studies should clarify whether this also applies to bladder irrigation procedures with antiseptics such as chlorhexidine. 14…”

Section: Discussionmentioning

confidence: 99%

Pilot study on the effects of intravesical oxybutynin hydrochloride instillations on the validity of doping control urine samples

Walpurgis

Scheiff²,

Welz³

et al. 2019

Drug Testing and Analysis

View full text Add to dashboard Cite

According to class M2.1 of the World Anti‐Doping Agency (WADA) Prohibited List, the manipulation of doping control urine samples to alter their integrity and validity is prohibited both in‐ and out‐of‐competition. However, some paraplegic athletes with an overactive bladder need to be regularly treated with anti‐cholinergic and anti‐spasmodic drugs such as oxybutynin, which are often administered intravesically to reduce the substantial side effects observed after oral application. So far, it remains unclear whether such bladder instillations have a negative impact on analytical procedures and thus represent an anti‐doping rule violation. Within this pilot study, urine samples were collected from five paraplegic athletes before and after an intravesical oxybutynin hydrochloride instillation. The samples were routinely tested for the presence of performance‐enhancing drugs and afterwards fortified with 25 model compounds representing different classes of doping agents (anabolic agents, cannabinoids, diuretics, glucocorticoids, hormone and metabolic modulators, and stimulants) at low and medium concentrations. Additionally, the pH value and specific gravity were measured and the presence of oxybutynin was qualitatively determined by gas chromatography−mass spectrometry (GC–MS). In initial testing procedures, all samples were tested negative. Oxybutynin was present in most of the samples but found to have no significant effect on the detectability of the 25 model compounds subsequently added to each urine specimen. Therefore, it can be concluded that intravesical instillations with oxybutynin hydrochloride do not alter the integrity and validity of doping control urine samples.

show abstract

Bladder irrigation with Chlorhexidine reduces bacteriuria in persons with spinal cord injury

Abstract: Bladder irrigation with chlorhexidine, using intermittent self-catheterization, reduced bacteriuria in the majority of subjects with spinal cord injury and bacteriuria. The addition of bladder irrigation was practically feasible in the short time-frame of this study.

Cited by 13 publications

References 17 publications

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

Comparison of the Effect of Perineal Care with Normal Saline and 2% Chlorhexidine Solution on the Rate of Catheter-Associated Urinary Tract Infection in Women Hospitalized in Intensive Care Units: A Quasi-Experimental Study

Pilot Ex Vivo and In Vitro Evaluation of a Novel Foley Catheter with Antimicrobial Periurethral Irrigation for Prevention of Extraluminal Biofilm Colonization Leading to Catheter-Associated Urinary Tract Infections (CAUTIs)

Pilot study on the effects of intravesical oxybutynin hydrochloride instillations on the validity of doping control urine samples

Contact Info

Product

Resources

About