Hydrogel/silver ion-coated urinary catheter reduces nosocomial urinary tract infection rates in intensive care unit patients: A multicenter study

Objectives. Indwelling urinary catheters are the leading source of nosocomi al urinary tract infections (NUTIs). The Bardex I.C. catheter is a hydrogel latex Foley catheter with a monolayer of silver metal applied to the inner and outer surfaces of the catheter. We investigated the Bardex I.C. cathet er for its ability to decrease the NUTI rate in critical care units. Methods. Five hospitals participated in a blind prospective study, exchangi ng the standard latex Foley catheter for the Bardex I.C. Foley catheter. Th e device use rate and NUTI rate were monitored. Data were collected and ana lyzed using Wilcoxon rank sum test and four-way analysis of variance. A cos t analysis was also performed. Results. The baseline period, intervention period, and number of device day s was similar for both periods. The unadjusted catheter-associated infectio n rate during the baseline and intervention periods was 7.1 and 4.5 infecti ons per 1000 catheter days, respectively (P < 0.01). The adjusted catheter- associated infection rate during the baseline and intervention periods was 8.1 and 4.9 infections per 1000 catheter days, respectively. This was not s tatistically significant (P = 0.13). Conclusions. A trend toward a reduction in NUTIs with the use of the hydrog el/silver-coated catheter was noted in all intensive care units at each ins titution as shown by the unadjusted and adjusted catheter-associated infect ion rates. One hospital demonstrated a statistically significant reduction in NUTIs. However, statistical significance was not met when the results we re adjusted. The cost analysis at one institution demonstrated cost savings with the use of the silver-coated catheter. Future analysis may require a double-blind, prospective-controlled study of longer duration to reach stat istical significance. (C) 1999, Elsevier Science Inc.