Advertisement

Use of silver-hydrogel urinary catheters on the incidence of catheter-associated urinary tract infections in hospitalized patients

      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.)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Haley RW
        • Culver DH
        • White JW
        • Morgan WM
        • Emori TG.
        The nationwide nosocomial infection rate: a new need for vital statistics.
        Am J Epidemiol. 1985; 121: 159-167
        • Jarvis WR.
        Selected aspects of the socioeconomic impact of nosocomial infection: morbidity, mortality, cost, and prevention.
        Infect Control Hosp Epidemiol. 1996; 17: 552-557
        • Karchmer TB
        • Giannetta ET
        • Muto CA
        • Strain BA
        • Farr BM.
        A randomized crossover study of silver-coated urinary catheters in hospitalized patients.
        Arch Intern Med. 2000; 160: 3294-3298
      1. MMWR Morb Mortal Wkly Rep. 1992; 41: 783-787
        • Saint S.
        Clinical and economic consequences of nosocomial catheter-related bacteriuria.
        Am J Infect Control. 2000; 28: 68-75
        • Schaeffer AJ
        • Story KO
        • Johnson SM.
        Effect of silver oxide/tricholoroisocyanuric acid antimicrobial urinary drainage system on catheter-associated bacteriuria.
        J Urol. 1988; 139: 69-73
        • Akiyama H
        • Okamoto S.
        Prophylaxis of indwelling urethral catheter infection. Clinical experience with a modified Foley catheter and drainage system.
        J Urol. 1979; 121: 40-42
        • Lunderberg T.
        Prevention of catheter-associated urinary tract infections by use of silver-impregnated catheters.
        Lancet. 1986; 2: 1031
        • Johnson JR
        • Roberts PL
        • Olsen RJ
        • Moyer KA
        • Stamm WE.
        Prevention of catheter-associated urinary tract infection with a silver oxide-coated urinary catheter: clinical and microbiologic correlates.
        J Infect Dis. 1990; 162: 1145-1150
        • Liedberg H
        • Lundberg T
        • Ekman P.
        Refinements in the coating of urethral catheters reduce the incidence of catheter-associated bacteriuria. An experimental and clinical study.
        Eur Urol. 1990; 17: 236-240
        • Riley DK
        • Classen DC
        • Stevens LE
        • Burke JP.
        A large randomized clinical trial of silver-impregnated urinary catheter: lack of efficacy and staphylococcal superinfection.
        Am J Med. 1995; 98: 349-356
        • Saint S
        • Elmore JG
        • Sullivan SD
        • Emerson SS
        • Koepsell TD.
        The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis.
        Am J Med. 1998; 105: 236-241
        • Maki DG
        • Knasinski V
        • Halvorson K
        • Tambyah PA.
        A novel silver-hydrogel-impregnated indwelling urinary catheter reduces CAUTIs: a prospective double-blind trial.
        Infect Control Hosp Epidemiol. 1998; 19 ([Abstract 10.]): 682
        • Ramirez R
        • Dobin A
        • Britten E
        • Wadman S.
        A silver opportunity for reducing nosocomial urinary tract infections.
        Infect Control Hosp Epidemiol. 1998; 17 ([Abstract S28]): 700
        • Verleyen P
        • De Ridder D
        • Van Poppel H
        • Baert L.
        Clinical application of the Bardex IC Foley catheter.
        Eur Urol. 1999; 36: 240-246
        • Bologna RA
        • Tu LM
        • Polansky M
        • Fraimow HD
        • Gordon DA
        • Whitmore KE.
        Hydrogel-silver ion-coated urinary catheter reduces nosocomial urinary tract infection rates in intensive care unit patients: a multicenter study.
        Urology. 1999; 54: 982-987
        • Saint S
        • Veenstra DL
        • Sullivan SD
        • Chenoweth C
        • Fendrick M.
        The potential clinical and economic benefits of silver alloy urinary catheters in preventing urinary tract infection.
        Arch Intern Med. 2000; 160: 2670-2675