Effect of a single-use sterile catheter for each void on the frequency of bacteriuria in children with neurogenic bladder on intermittent catheterization for bladder emptying.
OBJECTIVE
The frequency of bacteriuria is high in children with neurogenic bladder on intermittent catheterization for bladder emptying. In an effort to decrease bacteriuria, we examined whether the method of catheter care was responsible for the high rate of bacteriuria. For this, the frequency of bacteriuria was examined in the same patient on single-use sterile catheters and on reused clean catheters.


METHODS
A prospective, randomized, crossover trial was conducted with 10 patients who were randomized to 4 months of a new, sterile catheter for intermittent catheterization and 4 months of reuse of a clean catheter for intermittent catheterization. Each week, a urine sample was collected and symptoms of infection and medication use were recorded.


RESULTS
A total of 158 urine samples were collected during 164 patient-weeks on the new catheter method for each void; 115 (73%) were positive for a pathogen. Of the 161 samples collected during 169 patient-weeks on the standard, reuse method for voiding, 123 (76%) were positive (115 [73%] of 158 vs 123 [76%] of 161). Escherichia coli was the most common pathogen detected during both method periods.


CONCLUSIONS
A new, sterile catheter for each void did not decrease the high frequency of bacteriuria in patients with neurogenic bladder on intermittent catheterization.
Schlager
T A
TA
Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia, USA. tas8n@virginia.edu
Clark
M
M
Anderson
S
S
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D001437:Bacteriuria / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D002648:Child; D018592:Cross-Over Studies; D004209:Disposable Equipment / Q000382:microbiology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications; D013242:Sterilization / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000502:physiology; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy*; D014546:Urinary Catheterization / Q000295:instrumentation / Q000379:methods*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D014563:Urodynamics / Q000502:physiology