Ramezani Farahnaz, Khatiban Mahnaz, Rahimbashar Farshid, Soltanian Ali Reza, Mousavi-Bahar Seyed Habibollah, Elyasi Ensieh
Besat Specialized and Sub-specialized Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
Mother and Child Care Research Center, Department of Medical-Surgical Nursing, Department of Ethics Education in Medical Sciences, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
Health Serv Res Manag Epidemiol. 2023 Nov 9;10:23333928231211410. doi: 10.1177/23333928231211410. eCollection 2023 Jan-Dec.
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.
Catheter-induced urothelial injury is a key component in the development of urinary tract infections in catheterized patients.
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, ≥10 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.
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.
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.
探讨一种新型低轮廓导尿管对入住重症监护病房的昏迷患者导尿管相关尿路感染(CAUTI)发生率的影响。
导尿管引起的尿道上皮损伤是导尿患者发生尿路感染的关键因素。
在这项前瞻性随机双盲临床试验中,80例需要留置导尿管的患者被随机分为标准Foley导尿管组(对照组)和低轮廓导尿管组(试验组),每组各40例。观察昏迷患者的尿路感染迹象(即每毫升尿液中菌落形成单位≥10个、血尿、血清白细胞和体温),并在基线时以及导尿后第3天和第5天进行记录。采用SPSS - 20软件在95%置信水平下进行协方差分析。
与低轮廓导尿管组相比,Foley导尿管组尿菌落计数升高的患者比例有所增加(12.5%对5%)。然而,在控制抗生素剂量和液体摄入量后,两组之间的尿菌落计数和体温没有差异。低轮廓导尿管组患者的血尿和血清白细胞发生率显著低于Foley导尿管组。
新设计的低轮廓导尿管显示出降低留置导尿管患者CAUTI发生率的趋势。需要进一步进行更大样本量和更长随访时间的研究来证实其益处。