Comparison of effectiveness of two urinary drainage systems in intensive care unit: a prospective, randomized clinical trial.
OBJECTIVE
In a previous non-randomized study, we demonstrated that no difference occurred in the rate of acquisition of bacteriuria between a complex closed drainage system (CCDS) and a two-chamber drainage system (TCDS) in patients in an intensive care unit (ICU). To confirm this result, we performed a randomized, prospective, and powerful study assessing the effectiveness of the CCDS and the TCDS in ICU patients.


METHODS
Randomized, prospective, and controlled study.


METHODS
Medico-surgical intensive care unit (16 beds) in a teaching hospital.


METHODS
Three hundred and eleven patients requiring an indwelling urinary catheter for longer than 48 h were assigned individuals to the TCDS group or CCDS group to compare the rate of acquisition of bacteriuria.


RESULTS
Patients did not receive prophylactic antibiotics during placement management or catheter withdrawal. Urine samples were obtained weekly for the duration of catheterization and within 24 h after catheter removal, and each time symptoms of urinary infection were suspected. There was no statistical difference in the rate of bacteriuria between the two groups. Bacteriuria occurred in 8% and 8.5% of patients for TCDS and CCDS, respectively. Rates of urinary tract infection were 12.1 and 12.8 episodes per 1,000 days of catheter.


CONCLUSIONS
This randomized study, that compares the effectiveness of a TCDS and a CCDS in ICU patients, confirms the results of our previous study. No differences were noted between the two systems (a =0.05). The higher cost of CCDS is not justified for ICU patients.
Leone
Marc
M
Intensive Care Unit and Trauma Center, Nord Hospital, Marseilles University Hospital System, AP-HM, Marseilles School of Medicine, 13915, Marseilles, France. marc.leone@ap-hm.fr
Garnier
Franck
F
Antonini
François
F
Bimar
Marie-Christine
MC
Albanèse
Jacques
J
Martin
Claude
C
D000328:Adult; D001437:Bacteriuria / Q000453:epidemiology* / Q000517:prevention & control; D002408:Catheters, Indwelling / Q000191:economics; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000517:prevention & control*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014546:Urinary Catheterization / Q000191:economics / Q000295:instrumentation*; D014552:Urinary Tract Infections / Q000517:prevention & control*