title: Incidence of urinary tract infections in patients with short-term indwelling urethral catheters: a comparison between a 3-day urinary drainage bag change and no change regimens.
abstract: BACKGROUND
  The current practice of caring for hospitalized patients with indwelling urethral catheters in Siriraj Hospital is to change the drainage bag every 3 days. In an extensive medical literature search, no evidence was noted to support this practice.
  
  
  OBJECTIVE
  The purpose of this study was to compare the incidence of catheter-associated urinary tract infections (UTI) in hospitalized patients with indwelling catheters who receive a drainage bag change every 3 days with the incidence of UTI in patients who receive no bag change.
  
  
  METHODS
  This study was a randomized controlled trial. Participants and study procedures: Of the patients at Siriraj Hospital, 153 with an indwelling urinary catheter for at least 3 days were randomized to a 3-day drainage bag change or a no change regimen. A urine sample was obtained from each patient for culture every 7 days, on the day the catheter was removed, or the day the patient was suspected of having a UTI.
  
  
  RESULTS
  Of the 153 study patients, 79 were randomized to the 3-day bag change regimen, and 74 patients were in the no-change group. Both groups were comparable for all baseline characteristics. The incidence of symptomatic UTI was 13.9% in the 3-day drainage bag change group and 10.8% in the no change group (P =.7). The incidence of asymptomatic UTI was 36.7% in the 3-day bag change group and 36.5% in the no change group (P =.9).
  
  
  CONCLUSIONS
  There is no evidence for the necessity of a bag change every 3 days at Siriraj Hospital; the urine bag can be left longer than 3 days. However, the appropriate frequency of urinary drainage bag change needs additional study because the sample size in this study does not rule out a false-negative result.
authors.affiliation: Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Anuwat
authors.initials: A
authors.lastname: Keerasuntonpong
authors.forename: Wannasit
authors.initials: W
authors.lastname: Thearawiboon
authors.forename: Anchalee
authors.initials: A
authors.lastname: Panthawanan
authors.forename: Thepnimitr
authors.initials: T
authors.lastname: Judaeng
authors.forename: Kanjana
authors.initials: K
authors.lastname: Kachintorn
authors.forename: Duangporn
authors.initials: D
authors.lastname: Jintanotaitavorn
authors.forename: Luckana
authors.initials: L
authors.lastname: Suddhisanont
authors.forename: Sribenja
authors.initials: S
authors.lastname: Waitayapiches
authors.forename: Surapee
authors.initials: S
authors.lastname: Tiangrim
authors.forename: Visanu
authors.initials: V
authors.lastname: Thamlikitkul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000382:microbiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology