Schlager T A, Clark M, Anderson S
Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia, USA.
Pediatrics. 2001 Oct;108(4):E71. doi: 10.1542/peds.108.4.e71.
The frequency of bacteriuria is high in children with neurogenic bladder on intermittent catheterization for bladder emptying. In an effort to decrease bacteriuria, we examined whether the method of catheter care was responsible for the high rate of bacteriuria. For this, the frequency of bacteriuria was examined in the same patient on single-use sterile catheters and on reused clean catheters.
A prospective, randomized, crossover trial was conducted with 10 patients who were randomized to 4 months of a new, sterile catheter for intermittent catheterization and 4 months of reuse of a clean catheter for intermittent catheterization. Each week, a urine sample was collected and symptoms of infection and medication use were recorded.
A total of 158 urine samples were collected during 164 patient-weeks on the new catheter method for each void; 115 (73%) were positive for a pathogen. Of the 161 samples collected during 169 patient-weeks on the standard, reuse method for voiding, 123 (76%) were positive (115 [73%] of 158 vs 123 [76%] of 161). Escherichia coli was the most common pathogen detected during both method periods.
A new, sterile catheter for each void did not decrease the high frequency of bacteriuria in patients with neurogenic bladder on intermittent catheterization.
对于因神经源性膀胱而需间歇性导尿以排空膀胱的儿童,菌尿症发生率较高。为降低菌尿症发生率,我们研究了导尿管护理方法是否是导致菌尿症高发的原因。为此,我们对同一患者分别使用一次性无菌导尿管和重复使用的清洁导尿管时的菌尿症发生频率进行了检测。
对10例患者进行了一项前瞻性、随机、交叉试验,这些患者被随机分为两组,分别接受为期4个月的新型无菌导尿管间歇性导尿,以及为期4个月的重复使用清洁导尿管间歇性导尿。每周收集一次尿液样本,并记录感染症状和用药情况。
在采用新型导尿管方法进行间歇性导尿的164个患者周期间,共收集了158份尿液样本;其中115份(73%)病原体检测呈阳性。在采用标准的重复使用导尿管方法进行间歇性导尿的169个患者周期间,共收集了161份样本,其中123份(76%)呈阳性(新型导尿管组158份样本中的115份[73%],重复使用导尿管组161份样本中的123份[76%])。在两个阶段检测出的最常见病原体均为大肠杆菌。
对于因神经源性膀胱而需间歇性导尿的患者,每次导尿使用新型无菌导尿管并不能降低菌尿症的高发率。