Hydrogel-Coated Urinary Catheter on Symptomatic Catheter-Associated Urinary Tract Infections

PURPOSE: The purpose of this study was to determine the effect of a silver-alloy hydrogel catheter on symptomatic catheter-associated urinary tract infections (CAUTIs). DESIGN: Multicenter before-after non-randomized cohort study. SUBJECTS AND SETTING: Seven acute care hospitals ranging in size from 124 to 607 beds participated in this study. The study population included adult patients with a positive urine culture 2 or more days after admission, who underwent Foley catheterization. METHODS: Catheter-associated urinary tract infection surveillance was conducted at each hospital for at least 3 months during the use of a standard catheter and 3 months during the use of the silver-alloy hydrogel catheter. Both the National Healthcare Safety Network (NHSN) surveillance and a clinical defi nition of CAUTI were used for rate calculation. RESULTS: A 47 % relative reduction in the CAUTI rate was observed with the silver-alloy hydrogel catheter compared to the standard catheter when both infec-tion defi nitions were used (0.945/1000 patient days vs 0.498/1000 patient days) (odds ratio = 0.53; P <.0001; 95 % CI: 0.45-0.62). When only NHSN-defi ned CAUTIs were considered, a 58 % relative reduction occurred in the silver-alloy hydrogel period (0.60/1000 patient days vs 0.25/1000 patient days) (odds ratio = 0.42; P <.0001; 95 % CI: 0.34-0.53). Antimicrobial days for CAUTIs decreased from 1165 (standard catheter period) to 406 (silver-alloy hydrogel period). CONCLUSIONS: Use of a silver-alloy hydrogel urinary cath-eter reduced symptomatic CAUTI occurrences as defi ned by both NHSN and clinical criteria. KEY WORDS: catheter-associated urinary tract infection, Foley catheter, silver alloy catheter, silver catheter