Catheter-associated urinary tract infections and other infections in patients hospitalized for acute stroke: A prospective cohort study of two different silicone catheters.
OBJECTIVE
Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection. The primary aim of this study was to investigate whether the use of a silicone catheter coated with an ultrathin layer of a combination of the noble metals gold, palladium and silver (BIP™-silicone catheter) could reduce the incidence of CAUTI and antibiotic prescription compared with a standard silicone catheter in a cohort of acute neurological patients suffering primarily from stroke. At the same time, all infectious events requiring prescription of an antimicrobial agent were registered and are reported.


METHODS
The study was designed as a crossover cohort study enrolling men and women aged over 18 years, requiring emergency management for stroke including the insertion of an indwelling catheter. Data on patient characteristics, urinary tract infections (UTIs), other infectious events and all antibiotic prescriptions were recorded prospectively.


RESULTS
The patients' characteristics differed in the two centres in terms of age but not in diagnosis distribution. UTIs were recorded in 78 (24.2%) of the patients, ahead of pulmonary tract infections (n = 65; 20.2%). There was no difference in terms of CAUTI in the two catheter groups, even in subgroups with catheter treatment for 1 week or less. The patients with a diagnosed UTI required 3.5 more days of hospitalization than those without a UTI.


CONCLUSIONS
CAUTIs were the most frequent healthcare-associated infections, slightly ahead of pulmonary tract infections. No advantages of the coated catheter could be found in this cohort of critically ill patients.
a Faculty of Health and Society , Malmö University , Malmö , Sweden.|b Department of Urology , Skåne University Hospital , Malmö , Sweden.
Karin
K
Stenzelius
c Department of Neurology and Rehabilitation Medicine , Skåne University Hospital , Lund , Sweden.
Liselott
L
Laszlo
c Department of Neurology and Rehabilitation Medicine , Skåne University Hospital , Lund , Sweden.
Magdalena
M
Madeja
c Department of Neurology and Rehabilitation Medicine , Skåne University Hospital , Lund , Sweden.|d Faculty of Health Sciences , Lund University , Lund , Sweden.
Hélène
H
Pessah-Rasmusson
b Department of Urology , Skåne University Hospital , Malmö , Sweden.
Magnus
M
Grabe
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology; D020099:Coated Materials, Biocompatible; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006046:Gold / Q000008:administration & dosage; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D010165:Palladium / Q000008:administration & dosage; D011446:Prospective Studies; D012828:Silicones; D012834:Silver / Q000008:administration & dosage; D020521:Stroke / Q000150:complications*; D062885:Urinary Catheters / Q000009:adverse effects* / Q000382:microbiology; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D020099:Coated Materials, Biocompatible; D012828:Silicones; D012834:Silver; D010165:Palladium; D006046:Gold
Acute neurological conditions; Bactiguard catheter; catheter-associated urinary tract infection (CAUTI); healthcare-associated infection; indwelling catheter; silicone catheter; stroke; urinary tract infection