Catheter-Associated Urinary Tract Infection in Critically Ill Patients: A Comparative Evaluation Between Latex Urinary Catheter and Metal Alloy-Coated Urinary Catheter

危重患者导尿管相关尿路感染:乳胶导尿管与金属合金涂层导尿管的比较评价

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Abstract

Background and objective Catheter-associated urinary tract infection (CAUTI) accounts for 9% of all hospital-acquired infections (HAI). This study aimed to assess the incidence of CAUTI among patients with two different types of urinary catheters: the latex urinary catheter and the latex-coated metal alloy urinary catheter, used in the ICU setting. Methods This was a randomized, prospective, single-blinded study involving 76 ICU patients requiring catheterization and admitted to the ICU for more than 48 hours. Patients were allocated to the metal alloy catheter group and latex catheter group, with a randomization ratio of 1:1. CAUTI incidence was assessed at study entry, after 48 hours in the ICU, day seven in ICU, as well as any signs or symptoms of CAUTI detected during ICU stay. For statistical analysis, categorical data were compared using the chi-square or Fischer's exact test, and clinical outcomes were compared using the t-test. Results: A total of 76 patients were initially recruited for the study; however, six of them dropped out, leaving 70 patients for the final assessment. The mean age of the cohort was 48.6 ± 19.2 years and a majority of them were of Malay race (70.0%) and male (61.4%). The mean Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 13.2 ± 4.0 and 6.1 ± 2.0 respectively. The mean ICU length of stay was 6 ± 1.58 days and the mean day of catheterization was 6 ± 1.54 days. One incidence of CAUTI was seen in the latex catheter group while no incidence was observed in the metal alloy group. Conclusions Based on our findings, there is no statistically significant difference in the incidence of CAUTI between the latex urinary catheter and the metal alloy urinary catheter groups for short-term catheterization in critically ill patients.

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