Clinical study on the effects of different frequency bladder irrigation on urinary tract infection and catheter colonization in patients with long-term indwelling urinary catheter

Abstract

Objective To investigate the effects of different frequency bladder irrigation on urinary tract infection and catheter colonization in patients with long-term indwelling urinary catheter and to select ideal irrigation frequency,so as to reduce infection.Methods Two hundred and seventy-five patients with long-term indwelling catheterization were randomly divided into 4 groups:group A (n =67) had bladder irrigation twice a day,group B (n =69) had bladder irrigation once a day,group C (n =70) had bladder irrigation twice a week,and group D (n =69) had no bladder irrigation at all.All the patients in the former 3 groups had exactly the same mode of bladder irrigation.After 3,7,14 and 21 days of catheterization,incidence rates of urinary tract infection for the four groups were statistically analyzed,and at day 21 bacterial isolation and culture in the midstream urine were performed and colony counting was recorded.Results At days 3,7,14 and 21,rates of incidence for the patients in group A were respectively 2.99％,10.45％,16.42％ and 35.82％ ; rates of incidence for the patients in group B were 0,10.14 ％,20.29％ and 33.33％ ; those for the patients in group C were 0,2.86 ％,10.00％ and 17.14％ and those for the patients in D group were 0,10.14 ％,23.19％ and 40.58％.No significant differences could be seen in the rates of incidence among the patients of the 4 groups after 3 days of treatment (P ＞ 0.05).After 7,14 and 21 days of treatment,incidence of urinary tract infection in the patients of group C was significantly lower than that of the other groups,while incidence for the patients in group D was significantly higher than that of the other groups (P ＜ 0.05).Colony counting of Escherichia coli,proteus,Klebsiella,Streptococcus faecalis and other pathogens in the patients of group C were (9.38 ±0.87),(6.33 ±0.54),(4.97 ±0.38),(2.12 ± 0.24) and (0.92 ±0.06) respectively,which were significantly lower than that of the other 3 groups (P ＜ 0.05).Conclusions Bladder irrigation could effectively reduce the incidence of urinary tract infection in patients with long-term indwelling catheterization,and frequent irrigation in our opinion was no good.With bladder irrigation twice a week,incidence rate of urinary tract infection for the patients with long-term indwelling catheterization was significantly lower than that of other patients,and it was indicated that irrigation twice a week was a more appropriate irrigation frequency. Key words: Bladder irrigation;  Catheterization;  Urinary tract infections;  Bacterial colonization