Abstract
Background: Urinary tract infections (UTIs) account for 40% of all nosocomial infections, and
about 80% of these are associated with the use of urinary catheters. They not only
contribute to excess morbidity and mortality, but they also significantly add to the
cost of hospitalization. Clinical trials with silver-coated urinary catheters have
shown conflicting results. However, recent trials with silver-hydrogel urinary catheters
have shown a reduction in nosocomial UTIs, and these catheters appear to offer cost
savings. Method: The University of Massachusetts Medical Center is a teaching, tertiary hospital with
18% of its beds in intensive care units. The silver-hydrogel urinary catheters were
introduced in October 1997. The rate of catheter-associated UTIs with silver-hydrogel
urinary catheter use was compared with a historical baseline UTI rate that was established
for January 1996 and January 1997 with the standard, noncoated catheters. The cost
of a nosocomial catheter-associated UTI was estimated by calculating the hospital
charges resulting from all urinary catheter-associated UTIs in 1 month. A cost-analysis
of silver-hydrogel urinary catheter use was performed. Results: The rate of catheter-associated UTIs for noncoated catheters was 4.9/1000 patient-days
compared with 2.7/1000 patient-days for the silver-hydrogel catheters, a reduction
of 45% (P =.1). The average cost (calculated with hospital charges) of a catheter-associated
UTI at our institution was estimated to be $1214.42, with a median of $613.72. The
estimated cost-saving ranged from $12,563.52 to $142,314.72. Conclusions: The use of silver-hydrogel urinary catheters resulted in a nonsignificant reduction
in catheter-associated UTIs and a modest cost-saving. (Am J Infect Control 2002;30:221-5.)
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Article info
Footnotes
*Reprint requests: Kwan Kew Lai, DMD, MD, UMass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655.
Identification
Copyright
© 2002 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
