A prospective interventional study to examine the effect of a silver alloy and hydrogel-coated catheter on the incidence of catheter-associated urinary tract infection.
INTRODUCTION
Catheter-associated urinary tract infection is a major hospital-acquired infection. This study aimed to analyse the effect of a silver alloy and hydrogel-coated catheter on the occurrence of catheter-associated urinary tract infection.


METHODS
This was a 1-year prospective study conducted at a single centre in Hong Kong. Adult patients with an indwelling urinary catheter for longer than 24 hours were recruited. The incidence of catheter-associated urinary tract infection in patients with a conventional latex Foley catheter without hydrogel was compared with that in patients with a silver alloy and hydrogel-coated catheter. The most recent definition of urinary tract infection was based on the latest surveillance definition of the National Healthcare Safety Network managed by Centers for Disease Control and Prevention.


RESULTS
A total of 306 patients were recruited with a similar ratio between males and females. The mean (standard deviation) age was 81.1 (10.5) years. The total numbers of catheter-days were 4352 and 7474 in the silver-coated and conventional groups, respectively. The incidences of catheter-associated urinary tract infection per 1000 catheter-days were 6.4 and 9.4, respectively (P=0.095). There was a 31% reduction in the incidence of catheter-associated urinary tract infection per 1000 catheter-days in the silver-coated group. Escherichia coli was the most commonly involved pathogen (36.7%) of all cases. Subgroup analysis revealed that the protective effect of silver-coated catheter was more pronounced in long-term users as well as female patients with a respective 48% (P=0.027) and 42% (P=0.108) reduction in incidence of catheter-associated urinary tract infection. The mean catheterisation time per person was the longest in patients using a silver-coated catheter (17.0 days) compared with those using a conventional (10.8 days) or both types of catheter (13.6 days) [P=0.01].


CONCLUSIONS
Silver alloy and hydrogel-coated catheters appear to be effective in preventing catheter-associated urinary tract infection based on the latest surveillance definition. The effect is perhaps more prominent in long-term users and female patients.
['Chung|P Hy|PH|', 'Wong|C Wy|CW|', 'Lai|C Kc|CK|', 'Siu|H K|HK|', 'Tsang|D Nc|DN|', 'Yeung|K Y|KY|', 'Ip|D Km|DK|', 'Tam|P Kh|PK|']
D000368:Aged D000369:Aged, 80 and over D000497:Alloys D055499:Catheter-Related Infections D002408:Catheters, Indwelling D003428:Cross Infection D005260:Female D006801:Humans D020100:Hydrogels D015994:Incidence D008297:Male D011446:Prospective Studies D012737:Sex Factors D012834:Silver D013997:Time Factors D014546:Urinary Catheterization D014552:Urinary Tract Infections
Urinary tract infections Catheter-related infections Gold alloys/therapeutic use Hydrogel/therapeutic use Silver/therapeutic use