Evaluating the Potential of a New Low-Profile Urinary Catheter in Preventing Catheter-Associated Urinary Tract Infections: A Prospective Randomized Blinded Clinical Trial

Overview

Journal Health Serv Res Manag Epidemiol

Publisher Sage Publications

Specialty Public Health

Date 2023 Nov 13

PMID 37954479

Authors

Farahnaz Ramezani

Mahnaz Khatiban

Farshid Rahimbashar

Ali Reza Soltanian

Seyed Habibollah Mousavi-Bahar

Ensieh Elyasi

Affiliations

Soon will be listed here.

Abstract

Aim: To investigate the efficacy of a new low-profile catheter on incidence of the catheter-associated urinary tract infections (CAUTI) in comatose patients admitted to the intensive care unit.

Background: Catheter-induced urothelial injury is a key component in the development of urinary tract infections in catheterized patients.

Methods: In this prospective randomized blinded clinical trial, 80 patients requiring indwelling urinary catheterization were equally randomized to either the standard Foley catheter (control) or the low-profile catheter (experimental) group. The signs of urinary tract infection for comatose patients were considered (ie, ≥10 of colony-forming unit/milliliter of urine, hematuria, serum leukocytes, and body temperature) and recorded at baseline and on days 3 and 5 after catheterization. The analysis of covariance was applied by the SPSS-20 software at a 95% confidence level.

Results: An increasing proportion of patients with elevated urinary colony counts were seen in the Foley catheter group compared with the low-profile catheter group (12.5% vs 5%). However, there were no between-group differences in the urinary colony counts and body temperature after controlling for antibiotic doses and fluid intake. Patients in the low-profile catheter group had significantly lower rates of hematuria and serum leukocytes than those in the Foley catheter group.

Conclusion: A newly designed low-profile urinary catheter has demonstrated a trend toward reducing the incidence of CAUTI in patients with indwelling urinary catheters. Further studies with larger sample sizes and follow-up are needed to confirm the benefits.

Citing Articles

Open-ended urethral catheters reduce catheter obstruction after hypospadias repair.

Zhao X, Yu K, Fang E, Li N Front Pediatr. 2025; 12:1402440.

PMID: 39748814 PMC: 11693663. DOI: 10.3389/fped.2024.1402440.

References

Hollingsworth M, Quiroz F, Guralnick M . The management of retained Foley catheters. Can J Urol. 2004; 11(1):2163-6. View

Lucke-Wold B, Vaziri S, Scott K, Busl K . Urinary dysfunction in acute brain injury: A narrative review. Clin Neurol Neurosurg. 2019; 189:105614. DOI: 10.1016/j.clineuro.2019.105614. View

Sabir N, Ikram A, Zaman G, Satti L, Gardezi A, Ahmed A . Bacterial biofilm-based catheter-associated urinary tract infections: Causative pathogens and antibiotic resistance. Am J Infect Control. 2017; 45(10):1101-1105. DOI: 10.1016/j.ajic.2017.05.009. View

Schweiger A, Kuster S, Maag J, Zullig S, Bertschy S, Bortolin E . Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes. J Hosp Infect. 2020; 106(2):364-371. DOI: 10.1016/j.jhin.2020.07.002. View

Aljohi A, Hassan H, Gupta R . The efficacy of noble metal alloy urinary catheters in reducing catheter-associated urinary tract infection. Urol Ann. 2017; 8(4):423-429. PMC: 5100146. DOI: 10.4103/0974-7796.192099. View

Sampathkumar P . Reducing catheter-associated urinary tract infections in the ICU. Curr Opin Crit Care. 2017; 23(5):372-377. DOI: 10.1097/MCC.0000000000000441. View

Tortella F, Leung L . Traumatic Brain Injury and Polytrauma in Theaters of Combat: The Case for Neurotrauma Resuscitation?. Shock. 2015; 44 Suppl 1:17-26. DOI: 10.1097/SHK.0000000000000380. View

Li F, Song M, Xu L, Deng B, Zhu S, Li X . Risk factors for catheter-associated urinary tract infection among hospitalized patients: A systematic review and meta-analysis of observational studies. J Adv Nurs. 2018; 75(3):517-527. DOI: 10.1111/jan.13863. View

Mishra S . Tragedy of Inappropriately Managed Foley Catheter. J Obstet Gynaecol India. 2016; 66(Suppl 2):679-682. PMC: 5080259. DOI: 10.1007/s13224-016-0884-0. View

10.

Hickling D, Sun T, Wu X . Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection. Microbiol Spectr. 2015; 3(4). PMC: 4566164. DOI: 10.1128/microbiolspec.UTI-0016-2012. View

11.

Geneva I, Cuzzo B, Fazili T, Javaid W . Normal Body Temperature: A Systematic Review. Open Forum Infect Dis. 2019; 6(4):ofz032. PMC: 6456186. DOI: 10.1093/ofid/ofz032. View

12.

Tominaga G, Dhupa A, McAllister S, Calara R, Peters S, Stuck A . Eliminating catheter-associated urinary tract infections in the intensive care unit: is it an attainable goal?. Am J Surg. 2014; 208(6):1065-70. DOI: 10.1016/j.amjsurg.2014.08.013. View

13.

Sklar D, Diven B, Jones J . Incidence and magnitude of catheter-induced hematuria. Am J Emerg Med. 1986; 4(1):14-6. DOI: 10.1016/0735-6757(86)90242-1. View

14.

Feneley R, Hopley I, Wells P . Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol. 2015; 39(8):459-70. PMC: 4673556. DOI: 10.3109/03091902.2015.1085600. View

15.

Greenberg J, Grazul-Bilska A, Webb B, Sun X, Vonnahme K . A Preliminary Evaluation of Ovine Bladder Mucosal Damage Associated With 2 Different Indwelling Urinary Catheters. Urology. 2017; 110:248-252. DOI: 10.1016/j.urology.2017.08.020. View

16.

Bennett E, VanBuren J, Holubkov R, Bratton S . Presence of Invasive Devices and Risks of Healthcare-Associated Infections and Sepsis. J Pediatr Intensive Care. 2019; 7(4):188-195. PMC: 6506685. DOI: 10.1055/s-0038-1656535. View

17.

Clarke K, Hall C, Wiley Z, Tejedor S, Kim J, Reif L . Catheter-Associated Urinary Tract Infections in Adults: Diagnosis, Treatment, and Prevention. J Hosp Med. 2019; 15(9):552-556. DOI: 10.12788/jhm.3292. View

18.

Ramezani F, Khatiban M, Rahimbashar F, Soltanian A . Efficacy of bladder irrigation in preventing urinary tract infections associated with short-term catheterization in comatose patients: A randomized controlled clinical trial. Am J Infect Control. 2018; 46(10):e45-e50. DOI: 10.1016/j.ajic.2018.05.009. View

19.

Rabinstein A, Sandhu K . Non-infectious fever in the neurological intensive care unit: incidence, causes and predictors. J Neurol Neurosurg Psychiatry. 2007; 78(11):1278-80. PMC: 2117587. DOI: 10.1136/jnnp.2006.112730. View

20.

Nicolle L . Catheter associated urinary tract infections. Antimicrob Resist Infect Control. 2014; 3:23. PMC: 4114799. DOI: 10.1186/2047-2994-3-23. View