Noble metal alloy-coated latex versus silicone Foley catheter in short-term catheterization: A randomized controlled study

Abstract

Objective. The primary aim of this study was to compare the incidence of catheter-associated bacteriuria with a noble metal alloy-coated latex catheter or a non-coated silicone catheter in patients undergoing elective orthopaedic surgery with short-term catheterization. Secondary objectives included identifying risk factors for bacteriuria and catheter-associated urinary tract symptoms. Material and methods. The study compared 217 patients randomized to and receiving a silicone catheter with 222 patients treated with a coated latex catheter. Before removal of the catheter a sample for urinary culture was obtained. Bacteriuria was defined as the growth of ≥100 000 cfu/ml. A logistic regression model was used to identify risk groups for bacteriuria. Patients were interviewed about urinary tract symptoms during and after catheterization. Results. The incidence of bacteriuria was 1.5% with the coated latex catheter and 5.5% with the silicone catheter (p = 0.027) after a mean period of 2 days' catheterization time. Female gender (odds ratio 6.02) and obesity (odds ratio 5.08) were significant risk factors for bacteriuria. A quarter of the patients reported at least one symptom from the urinary tract during and after catheterization. Most patients defined the symptoms as “yes, a little” and a few consulted a healthcare professional because of the symptoms. Conclusion. This study confirmed previous results that the noble metal alloy coating significantly reduces the risk of catheter-associated bacteriuria in short-term catheterization (1–3 days). Female gender and obesity were significant risk factors for developing bacteriuria, while the use of an open drainage system and insertion of the catheter on the ward were not.

Key Words::

• Bacteriuria
• catheter-associated urinary tract infection
• Noble metal alloy-coated Foley catheter
• orthopaedic surgery
• silicone Foley catheter
• randomized controlled trial

Acknowledgements

The study was financed by Region Skåne, Foundation of Lund University Hospital and the orthopaedic and urology departments. It was also supported by Bactiguard AB. BCT-Consult Helena Lomberg confirmed that the study followed good clinical trial practice. PhD Assistant Professor Ulf Jakobsson was responsible for statistical advice, Dr Åsa Ljung for microbiological expertise and Alan Crosier for corrections to the English language. Finally, many thanks to all staff at the orthopaedic departments in Hässleholm, Lund and Trelleborg, who did a great job with the data collection.

Declaration of interest: I (Karin Stenzelius) hereby declare that there was no conflict of interest in the present study. Even though the study was partly founded by Bactiguard AB, I hereby declare that the study was initiated from the clinical view and not as a request from Bactiguard AB. Furthermore, the design, data collection and analysis have been done totally without any insight from Bactiguard AB. I had full access to all of the data in this study and I take complete responsibility for the integrity of the data and the accuracy of the data analysis.