A prospective trial of a novel, silicone-based, silver-coated foley catheter for the prevention of nosocomial urinary tract infections.
OBJECTIVE
To evaluate the efficacy of silicone-based, silver ion-impregnated urinary catheters in the prevention of nosocomial urinary tract infections (NUTIs).


METHODS
Prospective, crossover study to compare the efficacy of a silicone-based, hydrogel-coated, silver-impregnated Foley catheter with that of a silicone-based, hydrogel-coated catheter in the prevention of NUTIs.


METHODS
Adult medical and surgical wards of a university teaching hospital.


RESULTS
A total of 3,036 patients with catheters were evaluated; 1,165 (38%) of the catheters were silver impregnated, and 1,871 (62%) were not silver impregnated. Study groups were not identical; there were more men, a shorter duration of catheterization, and fewer urine cultures per 1,000 catheter-days in the silver catheter group. The rate of NUTIs per 1,000 Foley-days was 14.29 in the silver catheter group, compared with 16.15 in the nonsilver catheter group (incidence rate ratio, 0.88; 95% confidence interval, 0.70-1.11; P = .29). The median length of catheterization prior to the onset of a urinary tract infection (ie, exposure time) was 4 days for each group. There were no differences in the recovery of gram-positive, gram-negative, or fungal organisms in NUTIs. In a multivariate survival analysis, no factors, including silver catheters, were protective against NUTI.


CONCLUSIONS
Unlike previous trials of latex-based, silver ion-impregnated Foley catheters, we found that silicone-based, silver-impregnated Foley catheters were not effective in preventing NUTIs; however, this study was affected by differences in the study groups. Prospective trials remain important in assessing the efficacy and cost-effectiveness of new silver-coated products.
Srinivasan
Arjun
A
Department of Hospital Epidemiology and Infection Control, John Hopkins Hospital, Baltimore, Maryland, USA. asrinivasan@cdc.gov
Karchmer
Tobi
T
Richards
Ann
A
Song
Xiaoyan
X
Perl
Trish M
TM
D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D018592:Cross-Over Studies; D004202:Disinfectants; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007477:Ions; D008297:Male; D011446:Prospective Studies; D012828:Silicones; D012834:Silver; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*
D004202:Disinfectants; D007477:Ions; D012828:Silicones; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D012834:Silver