A study to determine whether the use of a preconnect urinary catheter system reduces the incidence of nosocomial urinary tract infections

Abstract

osocomial urinary tract infection (NUTI) is a common problem in the UK and is often related to the use of urinary catheters. In the UK urinary catheters account for approximately 25 per cent of all healthcare-associated infections and can have a considerable financial burden on the health service. Bacteria may gain entry into the bladder of a catheterised patient via the intra-luminal route especially if accidental disconnection arises. A prospective study was undertaken to determine the NUTI rates in patients using a preconnected catheter system compared to a traditional bag and catheter system on three medical wards. A total of 205 patients were included in the study. The catheter-associated urinary tract infection rate (CAUTI) in the baseline was 37.8 per 1,000 catheter days and 22.4 per 1000 catheter days in the intervention group. The rates of CAUTI was 41 per cent lower in the intervention group. The data in this sample group suggests the use of the preconnected catheter offers some protection against infection. The use of the preconnected system is a new concept in the UK and further studies are required to evaluate its effectiveness. The results from this study suggest their use may help to reduce the risk of CAUTI in certain clinical areas.

Keywords

Preconnect urinary catheters urinary tract infections healthcare-associated infection

Get full access to this article

View all access options for this article.

References

Al-Juburi AZ , Cicmanec J. (1989) New apparatus to reduce urinary drainage with urinary tract infections. Urology 33: 97-101.

Banning M. (2005) Infections and their treatment in older people. Nursing Older People 17(2): 24-7.

Bryan CS , Reynolds KL (1984) Hospital-acquired bacteremic urinary tract infection: epidemiology and outcome. Journal of Urology 132: 494-8.

Burke JP , Larsen RA , Stevens BS (1986) Nosocomial bacteriuria: estimating the potential for prevention by closed sterile urinary drainage. Infect Control 7: 96-9.

Crow R. , Mulhall A. , Chapman R. (1988) Indwelling catheterisation and related nursing practice. Journal of Advanced Nursing 13: 489-95.

DeGroot-Kosolcharoen J. , Guse R. , Jones JM (1998). Evaluation of a urinary catheter with a preconnected closed drainage bag. Infection Control Hospital Epidemiology 9(2): 72-6.

Department of Health. (2003) Winning ways: working together to reduce healthcare-associated infections in England. Department of Health: London.

Donaldson L. (2002) Getting ahead of the curve: a strategy for combating infectious diseases (including other aspects of health protection). Department of Health: London.

Fleming A. , Day J. , Glanfield L. (2000) Registered nurse management of urinary catheters in a rehabilitation and long-term care hospital. International Journal of Nursing Practice 6(5): 237-46.

10.

Garibaldi RA , Burke JP , Britt MR , Miller MA , Smith CB (1980) Metal colonization and catheter-associated bacteriuria . New England Journal of Medicine 303: 316-8.

11.

Garner JS , Jarvis WR , Emori TG , Horan TC , Hughes JM (1988) CDC definitions for nosocomial infections. American Journal of Infection Control 16: 128-40.

12.

Glenister HM , Taylor LJ , Bartlett CL , Cooke EM , Mackintosh CA , Leigh DA (1992) An 11-month incidence study of infections in wards of a district general hospital. Journal of Hospital Infecion 21(4): 261-73.

13.

Glynn A. , Ward V. , Wilson J. (1997) Socio-economic burden of healthcare-associated infection. Public Health Laboratory Service: London.

14.

Huth TS , Burke JP , Larsen RA , Classen DC , Stevens LE (1992) Clinical trial of junction seal for the prevention of urinary catheter-associated bacteriuria. Arch Intern Med 152(4): 807-12.

15.

Leone M. , Garnier F. , Dubac M. , Bimar M. , Martin C. (2001) Prevention of nosocomial urinary tract infection in ICU patients. Chest 120(1): 220-4.

16.

Maki DG , Tambyah PA (2001) Engineering out the risk of infection with urinary catheters. Emerging Infectious Diseases 7(2): 1-5.

17.

McNulty C. , Freeman E. , Smith G. , Gunn K. , Foy C. , Tompkins D. , Brady A. , Cartwright K. (2003) Prevalence of urinary catheterisation in UK nursing homes. Journal of Hospital Infection 55: 119-23.

18.

Mulhall AB , King S. , Lee K. , Wiggington E. (1993) Maintenance of closed urinary drainage systems: are practitioners more aware of the dangers? Journal of Clinical Nursing 2(3): 135-40.

19.

National Audit Office. (2000) The management and control of hospital-acquired infection in acute NHS Trusts in England. The Stationery Office: London.

20.

National Audit Office. (2004) Improving patient care by reducing the risk of hospital acquired infection: a progress report. HC 876 Session 2003-2004: 14 July 2004. The Stationery Office. London.

21.

National Nosocomial Infections Surveillance System. (2004) National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004. American Journal of Infection Control 32: 470-85.

22.

Platt R. , Polk BF , Murdock B. , Rosner B. (1983) Reduction of mortality associated with nosocomial urinary tract infection. Lancet 1(8330): 893-7.

23.

Plowman, R. , Graves N. , Griffin M. , Roberts JA , Swan AV , Cookson B. , Taylor L. (1999) The socio-economic burden of hospital-acquired infection. Public Health Laboratory Service and The London School of Hygiene and Tropical Medicine: London: 12.

24.

Pratt RJ , Pellowe C. , Loveday HP , Robinson N. , Smith GW (2001) Preventing healthcare-associated infections. Phase 1: Guidelines for preventing hospital-acquired infections. Journal of Hospital Infection 47 (supplement): S1-S82.

25.

Schilling JD , Mulvey MA , Scott JH (2001) Dynamic interactions between host and pathogen during acute urinary tract infections. Urology 57(Supplement 6A): 56-61.

26.

Stamm WE (1991) Catheter-associated urinary tract infections: epidemiology, pathogenesis, and prevention. American Journal of Medicine 16: 65S-71S.

27.

Stricker PD , Grant Abf. (1988) Relative value of antibiotic and catheter care in the prevention of urinary tract infections after transurethral prostatic resection. British Journal of Urology 61: 494-7.

28.

Thomas LH , McColl E. , Cullum N. , Rousseau N. , (1999) Clinical guidelines in nursing, midwifery and the therapies: a systematic review. Journal of Advanced Nursing 30: 40-50.

29.

Warren JW (1996) Urethral catheters, condom catheters, and nosocomial urinary tract infections. Infection Control and Hospital Epidemiology 17: 212-4.

30.

Wille JC , Blusse van Oud Alblas A. , Thewessen EA (1993) Nosocomial catheter-associated bacteriuria: a clinical trial comparing two closed urinary drainage systems. J Hosp Infect 25(3): 191-8.