title: Multicenter cohort study to assess the impact of a silver-alloy and hydrogel-coated urinary catheter on symptomatic catheter-associated urinary tract infections.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of a silver-alloy hydrogel catheter on symptomatic catheter-associated urinary tract infections (CAUTIs).
  
  
  METHODS
  Multicenter before-after non-randomized cohort study.
  
  
  METHODS
  Seven acute care hospitals ranging in size from 124 to 607 beds participated in this study. The study population included adult patients with a positive urine culture 2 or more days after admission, who underwent Foley catheterization.
  
  
  METHODS
  Catheter-associated urinary tract infection surveillance was conducted at each hospital for at least 3 months during the use of a standard catheter and 3 months during the use of the silver-alloy hydrogel catheter. Both the National Healthcare Safety Network (NHSN) surveillance and a clinical definition of CAUTI were used for rate calculation.
  
  
  RESULTS
  A 47% relative reduction in the CAUTI rate was observed with the silver-alloy hydrogel catheter compared to the standard catheter when both infection definitions were used (0.945/1000 patient days vs 0.498/1000 patient days) (odds ratio = 0.53; P < .0001; 95% CI: 0.45-0.62). When only NHSN-defined CAUTIs were considered, a 58% relative reduction occurred in the silver-alloy hydrogel period (0.60/1000 patient days vs 0.25/1000 patient days) (odds ratio = 0.42; P < .0001; 95% CI: 0.34-0.53). Antimicrobial days for CAUTIs decreased from 1165 (standard catheter period) to 406 (silver-alloy hydrogel period).
  
  
  CONCLUSIONS
  Use of a silver-alloy hydrogel urinary catheter reduced symptomatic CAUTI occurrences as defined by both NHSN and clinical criteria.
authors.affiliation: James W. Lederer, MD, Vice President, Clinical Improvement at Novant Health, Winston-Salem, North Carolina. William R. Jarvis, MD, President, Jason and Jarvis Associates, LLC, Hilton Head Island, South Carolina. Lendon Thomas, BS, CIC, Clinical Specialist C. R. Bard. Inc., Bard Medical Division, Covington, Georgia. Jaime Ritter, MPH, CIC, Senior Manager C. R. Bard, Inc, Bard Medical Division, Covington, Georgia.
authors.forename: James W
authors.initials: JW
authors.lastname: Lederer
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
authors.forename: Lendon
authors.initials: L
authors.lastname: Thomas
authors.forename: Jaime
authors.initials: J
authors.lastname: Ritter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D006047:Gold Alloys / Q000627:therapeutic use*; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012834:Silver / Q000627:therapeutic use*; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000517:prevention & control* / Q000628:therapy
chemical_list: D006047:Gold Alloys; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D012834:Silver; C097100:Revalloy