Multicenter Cohort Study to Assess the Impact of a Silver-Alloy and Hydrogel-Coated Urinary Catheter on Symptomatic Catheter-Associated Urinary Tract Infections

Abstract

PURPOSE:The purpose of this study was to determine the effect of a silver-alloy hydrogel catheter on symptomatic catheter-associated urinary tract infections (CAUTIs).DESIGN:Multicenter before-after non-randomized cohort study.SUBJECTS AND SETTING:Seven acute care hospitals ranging in size from 124 to 607 beds participated in this study. The study population included adult patients with a positive urine culture 2 or more days after admission, who underwent Foley catheterization.METHODS:Catheter-associated urinary tract infection surveillance was conducted at each hospital for at least 3 months during the use of a standard catheter and 3 months during the use of the silver-alloy hydrogel catheter. Both the National Healthcare Safety Network (NHSN) surveillance and a clinical definition of CAUTI were used for rate calculation.RESULTS:A 47% relative reduction in the CAUTI rate was observed with the silver-alloy hydrogel catheter compared to the standard catheter when both infection definitions were used (0.945/1000 patient days vs 0.498/1000 patient days) (odds ratio = 0.53; P < .0001; 95% CI: 0.45–0.62). When only NHSN-defined CAUTIs were considered, a 58% relative reduction occurred in the silver-alloy hydrogel period (0.60/1000 patient days vs 0.25/1000 patient days) (odds ratio = 0.42; P < .0001; 95% CI: 0.34–0.53). Antimicrobial days for CAUTIs decreased from 1165 (standard catheter period) to 406 (silver-alloy hydrogel period).CONCLUSIONS:Use of a silver-alloy hydrogel urinary catheter reduced symptomatic CAUTI occurrences as defined by both NHSN and clinical criteria.

Catheter-associated urinary tract infections and other infections in patients hospitalized for acute stroke: A prospective cohort study of two different silicone catheters

“…A requirement was that the patients enrolled in the study would follow the well-established management flow of care and routines for the specific diagnoses included. There are reports that silicone catheters coated with some noble metals reduce CAUTI in defined hospitalized populations [8][9][10]. The present study could not, however, confirm any advantage of the intervention catheter type in this population of patients.…”

“…Different catheter materials have been studied. Silver alloy urinary catheters have been shown in some studies to reduce bacteriuria and symptomatic UTI [8][9][10]. However, the evidence for any major difference in terms of frequency of bacterial colonization and symptomatic UTI is still poor [4,11,12].…”

A prospective interventional study to examine the effect of a silver alloy and hydrogel--coated catheter on the incidence of catheter-associated urinary tract infection

“…Lack of effect is not surprising due to the short catheterisation time and low-risk patient group. In a more recent multicentre cohort study in 2014, Lederer et al 4 examined the impact of noble metal alloy catheters on symptomatic CA-UTI and antibiotic use based on the NHSN surveillance and concluded that a 58% relative reduction (P<0.0001) in NHSN-defined CA-UTI rate was observed and 60% fewer antibiotics were used when compared with conventional catheters.…”

“…4 Therefore, by prevention of CA-UTI, a significant reduction in morbidity and mortality, as well as the health care economic burden, can be anticipated.…”

The efficacy of noble metal alloy urinary catheters in reducing catheter-associated urinary tract infection

“…These catheters have been introduced into practice in the US and several studies support their efficacy, safety, and cost-effectiveness. [222324] However, the CAUTI-reducing effect observed in these studies varies considerably, suggesting that the efficacy is highly dependent on patient group characteristics, hospital and/or region, catheterization time period, and which definition of CAUTI has been used.…”