Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters

Abstract

Study design: This study was designed as a comparative cross-sectional cross-over trial on children performing clean intermittent catheterization (CIC) with reused catheters for 1 or 3 weeks. Objectives: To determine the incidence of symptomatic urinary tract infection (UTI) and bacteriuria (defined as colony count of ⩾ 10 5 colony forming units per ml of a single strain of organism) in these two different frequencies of catheter change. Setting: Multidisciplinary children's neurogenic bladder clinics at two tertiary care hospitals in Kuala Lumpur Malaysia. Methods: Forty children aged between 2 and 16 years performing CIC for at last 3 years were recruited. Medical and social data were obtained from case files. Baseline urine cultures were taken. All children changed CIC catheters once in 3 week for the first 9 weeks followed by once a week for the next 9 weeks. Three-weekly urine cultures were obtained throughout the study. Standardization of specimen collection, retrieval and culture was ensured between the two centers. Results: At baseline, 65% of children had bacteriuria. This prevalence rose to 74% during the 3-weekly catheter change and dropped to 34% during the weekly catheter change (Z-score 6.218; Po0.001). Persistence of bacteriuria (all three specimens in each 9-week period) changed significantly from 60 to 12.5%, respectively (Po0.005). There was no episode of UTI during the 18-week study period. Conclusion: Reuse of CIC catheters for up to 3 weeks in children with neurogenic bladders appears to increase the prevalence of bacteriuria but does not increase the incidence of symptomatic UTI.

Long-term outcome of paediatric spinal cord injury

“…Retrospective series in paediatric populations show good tolerability of this intervention 29 without increasing the incidence of urinary tract infection. 30 If urethral intermittent catheterisation is problematic, then a continent catheterisable abdominal conduit can be constructed using the Mitrofanoff principle. Patients who have severe incontinence may be managed with a containment strategy using pads (in either sex) or a penile sheath collection system.…”

Clean intermittent catheterization: Single use vs. reuse

“…No comparison to single-use of catheters was made. 17 A retrospective study by Krassioukov et al 18 (2015) surveyed athletes with spinal cord injuries (n = 61); they found that those who reused the catheters experienced 4±3 UTIs per year while the figures for single-users stood at only 1±1 UTI per year. This association between catheter reuse and UTI was statistically significant (p < .001).…”

A Review of Four Health Procedures That School Nurses May Encounter

“…In the school setting, the school nurse may perform or assist a student with clean intermittent catheterization (CIC). Undesirable health consequences, such as urinary tract infection and renal failure, can occur as a result of incomplete emptying of the bladder (Kanaheswari, Kavitha, & Rizal, 2015). The primary purpose of CIC in the school environment is to manage urinary incontinence caused by neurogenic bladder, reduce urinary tract infections, and preserve renal function.…”