Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Urogynecology Journal
Published in: International Urogynecology Journal 5/2019

01-05-2019 | Original Article

Randomized controlled trial of silver-alloy-impregnated suprapubic catheters versus standard suprapubic catheters in assessing urinary tract infection rates in urogynecology patients

Authors: Ruchira Singh, Erik D. Hokenstad, Sheila R. Wiest, Shunaha Kim-Fine, Amy L. Weaver, Michaela E. McGree, Christopher J. Klingele, Emanuel C. Trabuco, John B. Gebhart

Published in: International Urogynecology Journal | Issue 5/2019

Login to get access

Abstract

Introduction and hypothesis

Catheter-associated urinary tract infections (UTI) are the most common health-care-related infections. We aimed to compare the UTI rate among women undergoing urogynecological procedures with a silver-alloy suprapubic catheter (SPC) and a standard SPC, and identify the risk factors predisposing patients to UTI.

Methods

Patients who were to undergo placement of an SPC as part of pelvic organ prolapse surgery were enrolled between 1 August 2011 and 30 August 2017, and randomized to either standard SPC or silver-alloy SPC. Follow-up was performed at a postoperative visit or via a phone call at 6 weeks. The primary outcome was UTI.

Results

Of the 288 patients who were randomized, 127 with standard SPC and 137 with silver-alloy SPC were included in the analysis. Twenty-nine out of 123 women with standard SPC (23.6%) and 24 out of 131 (18.3%) with silver-alloy SPC were diagnosed with UTI within 6 weeks postoperatively (p = 0.30). In univariate analysis, non-white race (odds ratio [OR] 5.36, 95% CI 1.16–24.73) and diabetes (OR 2.80, 95% CI 1.26–6.23) were associated with increased risk of UTI. On multivariate analysis, only diabetes remained an independent risk factor. Comparisons between groups were evaluated using two-sample t test for age, Chi-squared tests for diabetes, and Wilcoxon rank sum test for all other variables.

Conclusion

There was only a 5% difference in 6-week UTI rates between those who received standard vs silver-alloy SPC; the study was not powered to detect such a small difference. Diabetes was identified as a risk factor for SPC-associated UTI in women undergoing pelvic reconstructive surgeries.
Literature
1.
Saint S, Veenstra DL, Sullivan SD, Chenoweth C, Fendrick AM. The potential clinical and economic benefits of silver alloy urinary catheters in preventing urinary tract infection. Arch Intern Med. 2000;160:2670–5.CrossRefPubMed
2.
Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011;32:101–14.CrossRefPubMed
3.
Warren JW, Platt R, Thomas RJ, Rosner B, Kass EH. Antibiotic irrigation and catheter-associated urinary-tract infections. N Engl J Med. 1978;299:570–3.CrossRefPubMed
4.
Haley RW, Hooton TM, Culver DH, Stanley RC, Emori TG, Hardison CD, et al. Nosocomial infections in US hospitals, 1975–1976: estimated frequency by selected characteristics of patients. Am J Med. 1981;70:947–59.CrossRefPubMed
5.
Tambyah PA, Knasinski V, Maki DG. The direct costs of nosocomial catheter-associated urinary tract infection in the era of managed care. Infect Control Hosp Epidemiol. 2002;23:27–31.CrossRefPubMed
6.
Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol. 2010;31(4):319–26.
7.
8.
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;105:236–41.CrossRefPubMed
9.
Johnson JR, Delavari P, Azar M. Activities of a nitrofurazone-containing urinary catheter and a silver hydrogel catheter against multidrug-resistant bacteria characteristic of catheter-associated urinary tract infection. Antimicrob Agents Chemother. 1999;43:2990–5.CrossRefPubMedPubMedCentral
10.
Johnson JR, Kuskowski MA, Wilt TJ. Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients antimicrobial urinary catheters. Ann Intern Med. 2006;144:116–26.CrossRefPubMed
11.
Pickard R, Lam T, MacLennan G, Starr K, Kilonzo M, McPherson G, et al. Antimicrobial catheters for reduction of symptomatic urinary tract infection in adults requiring short-term catheterisation in hospital: a multicentre randomised controlled trial. Lancet. 2012;380:1927–35.CrossRefPubMed
12.
Branagan GW, Moran BJ. Published evidence favors the use of suprapubic catheters in pelvic colorectal surgery. Dis Colon Rectum. 2002;45:1104–8.CrossRefPubMed
13.
Feiks A, Kosain K, Gruber W. Suprapubic bladder drainage versus a transurethral catheter in patients following anterior colporrhaphy. Wien Klin Wochenschr. 1987;99:268–72.PubMed
14.
Krisman AM, Henderson RB. Suprapubic bladder drainage following anterior vaginal wall repair. Can Med Assoc J. 1969;101:164–6.PubMedPubMedCentral
15.
16.
Chung CP, Kuehl TJ, Harris SK, McBride MM, Larsen WI, Yandell PM, et al. Incidence and risk factors of postoperative urinary tract infection after uterosacral ligament suspension. Int Urogynecol J. 2012;23:947–50.CrossRefPubMed
17.
Rogers RG, Kammerer-Doak D, Olsen A, Thompson PK, Walters MD, Lukacz E, et al. A randomized, double-blind, placebo-controlled comparison of the effect of nitrofurantoin monohydrate macrocrystals on the development of urinary tract infections after surgery for pelvic organ prolapse and/or stress urinary incontinence with suprapubic catheterization. Obstet Gynecol. 2004;191:182–7.
18.
Nygaard I, Brubaker L, Chai TC, Markland AD, Menefee SA, Sirls L, et al. Risk factors for urinary tract infection following incontinence surgery. Int Urogynecol J. 2011;22:1255–65.CrossRefPubMedPubMedCentral
19.
Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, et al. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med. 2001;134:663–94.CrossRefPubMed
20.
21.
Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010;50:625–63.CrossRefPubMed
22.
23.
Liedberg H, Lundeberg T. Silver alloy coated catheters reduce catheter-associated bacteriuria. BJU Int. 1990;65:379–81.CrossRef
24.
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;160:3294–8.CrossRefPubMed
25.
Gebhart JB, Dixon DA, Trabuco EC, Klingele CJ, Bagniewski SM, Weaver AL. Three-year outcomes of uretex urethral support system for treatment of stress urinary incontinence. Int Urogynecol J. 2008;19:1075–9.CrossRef
26.
27.
28.
Sutkin G, Alperin M, Meyn L, Wiesenfeld HC, Ellison R, Zyczynski HM. Symptomatic urinary tract infections after surgery for prolapse and/or incontinence. Int Urogynecol J. 2010;21:955–61.CrossRefPubMed
29.
Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE, et al. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 2007;356:2143–55.CrossRefPubMed
30.
Metadata
Title
Randomized controlled trial of silver-alloy-impregnated suprapubic catheters versus standard suprapubic catheters in assessing urinary tract infection rates in urogynecology patients
Authors
Ruchira Singh
Erik D. Hokenstad
Sheila R. Wiest
Shunaha Kim-Fine
Amy L. Weaver
Michaela E. McGree
Christopher J. Klingele
Emanuel C. Trabuco
John B. Gebhart
Publication date
01-05-2019
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 5/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-018-3726-z

Other articles of this Issue 5/2019

International Urogynecology Journal 5/2019 Go to the issue

Original Article

Functional outcomes of synthetic tape and mesh revision surgeries: a monocentric experience

Original Article

A Danish national population-based cohort study of synthetic midurethral slings, 2007–2011

Original Article

Documenting pessary offer prior to hysterectomy for management of pelvic organ prolapse

Review Article

Patient-reported outcome measures which assess body image in urogynaecology patients: a systematic review

Original Article

What is the ideal antibiotic prophylaxis for intravesically administered Botox injection? A comparison of two different regimens

Original Article

Association of baseline severity of lower urinary tract symptoms with the success conservative therapy for urinary incontinence in women