Stenzelius Karin, Persson Siv, Olsson Ulla-Britt, Stjärneblad Monica
Urology Department , University Hospital of Skane, Malmö , Sweden.
Scand J Urol Nephrol. 2011 Sep;45(4):258-64. doi: 10.3109/00365599.2011.560007. Epub 2011 Mar 31.
The primary aim of this study was to compare the incidence of catheter-associated bacteriuria with a noble metal alloy-coated latex catheter or a non-coated silicone catheter in patients undergoing elective orthopaedic surgery with short-term catheterization. Secondary objectives included identifying risk factors for bacteriuria and catheter-associated urinary tract symptoms.
The study compared 217 patients randomized to and receiving a silicone catheter with 222 patients treated with a coated latex catheter. Before removal of the catheter a sample for urinary culture was obtained. Bacteriuria was defined as the growth of ≥100 000 cfu/ml. A logistic regression model was used to identify risk groups for bacteriuria. Patients were interviewed about urinary tract symptoms during and after catheterization.
The incidence of bacteriuria was 1.5% with the coated latex catheter and 5.5% with the silicone catheter (p = 0.027) after a mean period of 2 days' catheterization time. Female gender (odds ratio 6.02) and obesity (odds ratio 5.08) were significant risk factors for bacteriuria. A quarter of the patients reported at least one symptom from the urinary tract during and after catheterization. Most patients defined the symptoms as "yes, a little" and a few consulted a healthcare professional because of the symptoms.
This study confirmed previous results that the noble metal alloy coating significantly reduces the risk of catheter-associated bacteriuria in short-term catheterization (1-3 days). Female gender and obesity were significant risk factors for developing bacteriuria, while the use of an open drainage system and insertion of the catheter on the ward were not.
本研究的主要目的是比较在接受择期骨科手术且需短期留置导尿管的患者中,使用贵金属合金涂层乳胶导尿管与未涂层硅胶导尿管的导管相关菌尿症发生率。次要目的包括确定菌尿症和导管相关尿路症状的危险因素。
该研究将217例随机分组并接受硅胶导尿管的患者与222例接受涂层乳胶导尿管治疗的患者进行比较。在拔除导尿管前获取一份尿培养样本。菌尿症定义为菌落形成单位(cfu)/毫升≥100000。采用逻辑回归模型确定菌尿症的风险组。在导尿期间及之后对患者进行关于尿路症状的访谈。
平均导尿2天后,涂层乳胶导尿管的菌尿症发生率为1.5%,硅胶导尿管为5.5%(p = 0.027)。女性(优势比6.02)和肥胖(优势比5.08)是菌尿症的显著危险因素。四分之一的患者在导尿期间及之后报告至少有一种尿路症状。大多数患者将症状定义为“有一点”,少数患者因这些症状咨询了医疗保健专业人员。
本研究证实了先前的结果,即贵金属合金涂层在短期导尿(1 - 3天)中显著降低了导管相关菌尿症的风险。女性和肥胖是发生菌尿症的显著危险因素,而使用开放引流系统和在病房插入导尿管则不是。