Silver hydrogel urinary catheters: Evaluation of safety and efficacy in single patient with chronic spinal cord injury

Abstract

Abstract-Urinary tract infections (UTIs) are a large health burden for patients with spinal cord injury (SCI) who have neurogenic bladder dysfunction, especially those patients using indwelling catheters. One method that has shown promise in recent years is the use of a silver hydrogel catheter (SHC). This article describes the outcome of a subject who was part of a prospective, randomized, double-blind study and assigned to use an SHC for 6 months. Using the indwelling SHC effectively prevented this subject from developing a symptomatic UTI. He did not display any symptoms suggestive of silver toxicity or increased serum levels of silver with chronic use of the device. Although no general conclusions can be drawn from this single-subject observation, the results suggest that SHC use has a positive effect. Use of this catheter for persons with neurogenic bladder dysfunction after SCI should be explored further with a study design that optimizes subject recruitment.

Long-term use of noble metal alloy coated urinary catheters reduces recurrent CAUTI and decreases proinflammatory markers

“…The results support the notion that the NMA coating on BIP Foleys may prevent new infections from occurring, and thereby improve the condition and quality of life for catheterized patients with recurring infections in the urinary tract. This is further supported by two previous studies, by Chung et al 22 and Estores et al, 35 evaluating the effect of NMA-coated catheters in long-term catheterized patients. 22,35 The anti-infective effect of this catheter type was found to be significant in both those studies.…”

“…This is further supported by two previous studies, by Chung et al 22 and Estores et al, 35 evaluating the effect of NMA-coated catheters in long-term catheterized patients. 22,35 The anti-infective effect of this catheter type was found to be significant in both those studies. The study by Estores et al 35 is also a case report of a neurogenic bladder dysfunction patient who became free from recurrent CAUTI after switch to the catheter with the NMA.…”

Review of Catheter-Associated Urinary Tract Infections and In Vitro Urinary Tract Models

“…Another antimicrobial that has been used in catheters is silver, either impregnated into the catheter's materials itself or as part of a hydrogel coating on the catheters surfaces [ 4 , 18 ]. The antimicrobial effects of silver have long been utilised in medical dressings for burns and pressure ulcers as well as consumer goods [ 33 ]. Silver exhibits broad-spectrum antimicrobial activity that is effective against both anaerobic and aerobic bacteria as well as both Gram-positive and Gram-negative bacteria [ 33 ].…”

“…The antimicrobial effects of silver have long been utilised in medical dressings for burns and pressure ulcers as well as consumer goods [ 33 ]. Silver exhibits broad-spectrum antimicrobial activity that is effective against both anaerobic and aerobic bacteria as well as both Gram-positive and Gram-negative bacteria [ 33 ]. Silver's mechanism of action involves the release of ions that cause oxidative damage to a bacterium's cellular DNA and disruption of the cell's membrane [ 36 ].…”

“…Silver's mechanism of action involves the release of ions that cause oxidative damage to a bacterium's cellular DNA and disruption of the cell's membrane [ 36 ]. Silver is medically important as it can be effective against antibiotic-resistant strains like methicillin-resistant Staphylococcus aureus (MRSA); however, some bacteria are now showing resistance to silver, including Proteus mirabilis, Enterobacter cloacae, Citrobacter freundii, and Klebsiella pneumoniae, with Proteus mirabilis' resistance to silver of particular interest to preventing CAUTIs [ 33 ]. Some studies have found that silver can be effective in controlling bacterial levels during short-term catheterisation; however, the silver was found to only delay the onset of bacteriuria and has not been proven effective in prevention of CAUTIs [ 41 , 42 ].…”