Evaluating the Potential of a New Low-Profile Urinary Catheter in Preventing Catheter-Associated Urinary Tract Infections: A Prospective Randomized Blinded Clinical Trial.
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引用次数: 0
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, ≥105 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.
目的:探讨新型低姿态导尿管对重症监护病房昏迷患者尿路感染(CAUTI)发生率的影响。背景:导尿诱导的尿路上皮损伤是导尿患者发生尿路感染的关键因素。方法:在本前瞻性随机盲法临床试验中,80例需要留置导尿的患者平均随机分为标准Foley导尿组(对照组)和低规格导尿组(实验组)。考虑昏迷患者的尿路感染征象(如尿、血尿、血清白细胞、体温≥105个菌落形成单位/毫升),并在基线和置管后第3天和第5天记录。协方差分析采用SPSS-20软件,置信水平为95%。结果:与低姿态导尿管组相比,Foley导尿管组尿菌落计数升高的患者比例增加(12.5% vs 5%)。然而,在控制抗生素剂量和液体摄入量后,尿菌落计数和体温在组间没有差异。低姿态导尿管组患者的血尿和血清白细胞率明显低于Foley导尿管组。结论:新设计的低姿态导尿管显示出降低留置导尿管患者CAUTI发生率的趋势。需要更大样本量的进一步研究和随访来证实其益处。