Catheter-associated bacteriuria. Failure to reduce attack rates using periodic instillations of a disinfectant into urinary drainage systems
R. L. Thompson, C. E. Haley, M. A. Searcy, S. M. Guenthner, D. L. Kaiser, D. H. Groschel, J. Y. Gillenwater and R. P. Wenzel
We assessed the efficacy of periodic instillations of hydrogen peroxide
into urinary drainage systems in the prevention of catheter-associated
bacteriuria in a prospective and randomized clinical study of 668 patients
with indwelling urethral catheters. Bacteriuria was documented in 68 (10%)
of the 668 patients after a mean duration of four days of catheterization.
There was no difference between the hydrogen peroxide group and the control
group in the mean duration of catheterization before the onset of
bacteriuria, in the attack rate for bacteriuria, or in the spectrum of
etiologic agents recovered. Bag contamination with the same organism
responsible for bacteriuria preceded infection in only five (7%) of the 68
patients, three patients using hydrogen peroxide and two in the control
group. We conclude that infections arising intraluminally from
contamination of the drainage bag are uncommon among catheterized patients
and that the periodic instillation of disinfectants into closed sterile
drainage systems is not effective in reducing the incidence of
catheter-associated bacteriuria.
