Clinical effectiveness of the silver-impregnated Foley with bacteriostatic tubing/bag system compared with standard latex catheters and standard drain systems

Abstract

BACKGROUND/OBJECTIVES: Catheter-associated urinary tract infections (CAUTIs) are the most frequently occurring healthcare-acquired infections (HAIs). Use of antiseptic urinary catheters has been reported to reduce risk of CAUTI. Few data exist on the combined value of antiseptic drainage systems along with antiseptic catheters. We compared rates of CAUTI using silver-coated Foley catheters with antiseptic-impregnated drainage system with standard Foleys and standard drainage system. METHODS: A baseline CAUTI rate was established over a 6-month timeframe using standard latex catheters and drain systems (Kendall/Tyco product). A retrospective review of the medical records was conducted of all qualifying positive urine cultures between March 1, 2003, and August 31, 2003. Strict qualifier parameters and case definitions were used. We used the CAUTI case definition reported by Ritter, Watson, et al., in “Redefining Catheter Associated UTI (CAUTI): Are New Definitions Necessary?” (APIC abstract, 2004). The Bardex® IC Complete Care™ system (Bard Medical, Covington, Georgia) with both antiseptic catheters and antiseptic drainage system was implemented as an intervention measure. A second retrospective review was conducted for qualifier records between January 1, 2004, and June 30, 2004, using the same qualifier criteria and case definitions. RESULTS: A total of 161 patient records qualified for the standard Foley baseline. From these, we identified 104 CAUTIs among 33,144 patient days. During the antiseptic catheter/drain system time frame, 113 records qualified, from which we identified 40 CAUTIs among 32,438 patient days. CAUTI rate was reduced from 3.13 cases/1000 patient days in the standard catheter period to 1.2 cases per 1000 patient days in the antiseptic catheter period. Relative risk of CAUTI = 0.393. (95% CI = −2.62 to −1.19, p = <0.0002). This represents a 61% rate reduction. CONCLUSIONS: Use of the silver-impregnated Foley with the bacteriostatic tubing/bag system significantly reduced the risk of CAUTI within our hospital, preventing more than 60 cases of CAUTI over a 6-month timeframe. BACKGROUND/OBJECTIVES: Catheter-associated urinary tract infections (CAUTIs) are the most frequently occurring healthcare-acquired infections (HAIs). Use of antiseptic urinary catheters has been reported to reduce risk of CAUTI. Few data exist on the combined value of antiseptic drainage systems along with antiseptic catheters. We compared rates of CAUTI using silver-coated Foley catheters with antiseptic-impregnated drainage system with standard Foleys and standard drainage system. METHODS: A baseline CAUTI rate was established over a 6-month timeframe using standard latex catheters and drain systems (Kendall/Tyco product). A retrospective review of the medical records was conducted of all qualifying positive urine cultures between March 1, 2003, and August 31, 2003. Strict qualifier parameters and case definitions were used. We used the CAUTI case definition reported by Ritter, Watson, et al., in “Redefining Catheter Associated UTI (CAUTI): Are New Definitions Necessary?” (APIC abstract, 2004). The Bardex® IC Complete Care™ system (Bard Medical, Covington, Georgia) with both antiseptic catheters and antiseptic drainage system was implemented as an intervention measure. A second retrospective review was conducted for qualifier records between January 1, 2004, and June 30, 2004, using the same qualifier criteria and case definitions. RESULTS: A total of 161 patient records qualified for the standard Foley baseline. From these, we identified 104 CAUTIs among 33,144 patient days. During the antiseptic catheter/drain system time frame, 113 records qualified, from which we identified 40 CAUTIs among 32,438 patient days. CAUTI rate was reduced from 3.13 cases/1000 patient days in the standard catheter period to 1.2 cases per 1000 patient days in the antiseptic catheter period. Relative risk of CAUTI = 0.393. (95% CI = −2.62 to −1.19, p = <0.0002). This represents a 61% rate reduction. CONCLUSIONS: Use of the silver-impregnated Foley with the bacteriostatic tubing/bag system significantly reduced the risk of CAUTI within our hospital, preventing more than 60 cases of CAUTI over a 6-month timeframe.