Srinivasan Arjun, Karchmer Tobi, Richards Ann, Song Xiaoyan, Perl Trish M
Department of Hospital Epidemiology and Infection Control, John Hopkins Hospital, Baltimore, Maryland, USA.
Infect Control Hosp Epidemiol. 2006 Jan;27(1):38-43. doi: 10.1086/499998. Epub 2006 Jan 6.
To evaluate the efficacy of silicone-based, silver ion-impregnated urinary catheters in the prevention of nosocomial urinary tract infections (NUTIs).
Prospective, crossover study to compare the efficacy of a silicone-based, hydrogel-coated, silver-impregnated Foley catheter with that of a silicone-based, hydrogel-coated catheter in the prevention of NUTIs.
Adult medical and surgical wards of a university teaching hospital.
A total of 3,036 patients with catheters were evaluated; 1,165 (38%) of the catheters were silver impregnated, and 1,871 (62%) were not silver impregnated. Study groups were not identical; there were more men, a shorter duration of catheterization, and fewer urine cultures per 1,000 catheter-days in the silver catheter group. The rate of NUTIs per 1,000 Foley-days was 14.29 in the silver catheter group, compared with 16.15 in the nonsilver catheter group (incidence rate ratio, 0.88; 95% confidence interval, 0.70-1.11; P = .29). The median length of catheterization prior to the onset of a urinary tract infection (ie, exposure time) was 4 days for each group. There were no differences in the recovery of gram-positive, gram-negative, or fungal organisms in NUTIs. In a multivariate survival analysis, no factors, including silver catheters, were protective against NUTI.
Unlike previous trials of latex-based, silver ion-impregnated Foley catheters, we found that silicone-based, silver-impregnated Foley catheters were not effective in preventing NUTIs; however, this study was affected by differences in the study groups. Prospective trials remain important in assessing the efficacy and cost-effectiveness of new silver-coated products.
评估含银离子的硅胶导尿管预防医院获得性尿路感染（NUTIs）的疗效。
前瞻性交叉研究，比较含银离子、水凝胶涂层的硅胶Foley导尿管与普通水凝胶涂层硅胶导尿管预防NUTIs的疗效。
某大学教学医院的成人内科和外科病房。
共评估了3036例留置导尿管患者；其中1165根（38%）导尿管含银离子，1871根（62%）不含银离子。研究组情况不同；含银导尿管组男性更多，导尿时间更短，每1000导尿日的尿培养次数更少。含银导尿管组每1000 Foley导尿日的NUTIs发生率为14.29，非含银导尿管组为16.15（发病率比，0.88；95%置信区间，0.70 - 1.11；P = 0.29）。每组尿路感染发作前的导尿中位时间（即暴露时间）均为4天。NUTIs中革兰氏阳性菌、革兰氏阴性菌或真菌的检出率无差异。在多变量生存分析中，包括含银导尿管在内的任何因素均未对NUTI起到预防作用。
与之前基于乳胶的含银离子Foley导尿管试验不同，我们发现含银离子的硅胶Foley导尿管在预防NUTIs方面无效；然而，本研究受到研究组差异的影响。前瞻性试验在评估新型涂银产品的疗效和成本效益方面仍然很重要。
