Menezes Fernando Gatti, Corrêa Luci, Medina-Pestana Jose Osmar, Aguiar Wilson Ferreira, Camargo Luis Fernando Aranha
Infection Control and Prevention Service, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Infectious Diseases Division, Internal Medicine Department, Universidade Federal de São Paulo, São Paulo, Brazil.
Transpl Infect Dis. 2019 Apr;21(2):e13031. doi: 10.1111/tid.13031. Epub 2018 Dec 5.
Urinary tract infections are frequent complications early after kidney transplantation, and the use of antimicrobial coated catheters in settings other than transplantation has shown promising results for infection prevention. The purpose of this study was to compare the efficacy of Nitrofurazone-coated silicone urinary catheters with non-impregnated silicone urinary catheters in reducing bacteriuria and urinary tract infections in kidney transplant recipients.
This single-center study, randomized controlled trial at the Hospital do Rim, a tertiary referral center in kidney transplantation, located in São Paulo, Brazil. Subjects involved living donor kidney transplant recipients, and were randomized 1:1 ratio with a computer-generated system to a Nitrofurazone-coated silicone urinary catheter and non-impregnated silicone urinary catheter from March 2013 to December 2014. Patients with asymptomatic bacteriuria or urinary tract infection at baseline, deceased kidney transplant donors, patients with known hypersensitivity to nitrofurantoin, pregnancy, and those refusing to sign the informed consent form were excluded from the study.
Two hundred fourteen subjects were randomized and one hundred seventy-six completed the study. There were no differences in the rates of asymptomatic bacteriuria (12.5% in the Nitrofurazone group and 11.4% in the control group, P = 0.99) and urinary tract infection (8% and 6.8%, P = 0.99) and the incidence of side effects was more frequent in the Nitrofurazone-impregnated silicone urinary catheter group (46.6% and 26.1%, P = 0.007).
The study suggests that there is no beneficial effect of the employment of Nitrofurazone-coated urinary catheter.
ISRCTN57888785.
尿路感染是肾移植术后早期常见的并发症，在移植以外的环境中使用抗菌涂层导管预防感染已显示出有前景的结果。本研究的目的是比较呋喃西林涂层硅胶导尿管与未浸渍硅胶导尿管在减少肾移植受者菌尿和尿路感染方面的疗效。
本单中心研究为一项随机对照试验，在位于巴西圣保罗的一家肾脏移植三级转诊中心——里姆医院进行。研究对象为活体供肾肾移植受者，从2013年3月至2014年12月，通过计算机生成系统以1:1的比例随机分为呋喃西林涂层硅胶导尿管组和未浸渍硅胶导尿管组。基线时有无症状菌尿或尿路感染的患者、已故肾移植供者、已知对呋喃妥因过敏的患者、孕妇以及拒绝签署知情同意书的患者被排除在研究之外。
214名受试者被随机分组，176名完成了研究。无症状菌尿发生率（呋喃西林组为12.5%，对照组为11.4%，P = 0.99）和尿路感染发生率（分别为8%和6.8%，P = 0.99）无差异，且呋喃西林浸渍硅胶导尿管组副作用发生率更高（分别为46.6%和26.1%，P = 0.007）。
该研究表明使用呋喃西林涂层导尿管没有有益效果。
ISRCTN57888785。
