A prospective trial of a novel, silicone-based, silver-coated foley catheter for the prevention of nosocomial urinary tract infections

  • Srinivasan A
  • Karchmer T
  • Richards A
 et al. 
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Abstract

OBJECTIVE: To evaluate the efficacy of silicone-based, silver ion-impregnated urinary catheters in the prevention of nosocomial urinary tract infections (NUTIs). DESIGN: 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. SETTING: 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

Author-supplied keywords

  • *Cross Infection/pc [Prevention & Control]
  • *Disinfectants
  • *Urinary Catheterization/is [Instrumentation]
  • *Urinary Tract Infections/pc [Prevention & Control
  • 0 (Disinfectants)
  • 0 (Ions)
  • 0 (Silicones)
  • 25852-47-5 (Hydrogel)
  • 7440-22-4 (Silver)
  • Adult
  • Catheters,Indwelling/ae [Adverse Effects]
  • Comparative Study
  • Cross Infection/et [Etiology]
  • Cross-Over Studies
  • Female
  • Humans
  • Hydrogel
  • Incidence
  • Infection Control
  • Ions
  • Male
  • Maryland
  • Prospective Studies
  • Research Support,Non-U.S.Gov't
  • Silicones
  • Silver
  • Survival Analysis
  • Treatment Outcome
  • United States
  • Urinary Catheterization/ae [Adverse Effects]
  • Urinary Tract Infections/et [Etiology]

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Authors

  • A Srinivasan

  • T Karchmer

  • A Richards

  • X Song

  • T M Perl

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