A prospective, controlled, randomized study of the effect of a slow‐release silver device on the frequency of urinary tract infection in newly catheterized patients

Abstract

Objective To test the effect on urinary tract infections (UTIs) in patients needing continuous indwelling catheterization, of a newly designed urine-collecting system containing an antibacterial device which slowly releases silver ions onto the inner surface of the system. Patients and methods The study comprised a prospective controlled randomized trial; 213 patients ful®lled the inclusion criteria. They were randomized to a urine drainage system (comprising a Unometer 400 metering system or PP 2000N closed urine-bag system, both from Maersk Medical, Denmark) either with or without the antibacterial device. The ef®cacy was assessed as the number of UTIs and the time to infection in the 170 patients eligible for analysis. Results There were fewer UTIs in those using the system containing the antibacterial device (19% vs 24%), but the difference was not statistically signi®cant (P<0.05). Conclusion The potential importance of different infection routes were highlighted, suggesting that modi®cations to Foley catheters and urine-collecting systems attempting to prevent UTIs should focus not only on the intraluminal pathway, but on the internal and external pathways of infection.

Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

“…Randomized trials of the addition of antimicrobials (including chlorhexidine, hydrogen peroxide, povidone-iodine, or slowly released silver ions) to the drainage bag to decrease the risk of CA-bacteriuria have generally shown no benefit [29,150,[272][273][274]. For example, in 668 patients with indwelling urethral catheters (mean duration, 4 days), there was no difference between the hydrogen peroxide group and the control group with respect to the mean duration of catheterization before the onset of bacteriuria, the rate of CA-bacteriuria, or the spectrum of etiologic agents recovered [150].…”

Properties of Nanosilver Coatings on Polymethyl Methacrylate

“…In comparison to organic antibiotic, silver ions are active against a broad spectrum of bacteria, viruses, and fungi, and the risk of resistance development is much lower. For these reasons, medical devices like catheters (18)(19)(20)(21)(22)(23)(24)(25), heart valve sewing cuffs (21,26,27), wound dressings (2,(28)(29)(30)(31)(32)(33), or sutures (21,34) are coated with elemental silver (2,21,26,27,30,31,33), silver sulfadiazine (18, 19, 21-23, 28-30, 33), silver ion containing hydrogels (21,25,33), or silver ion doped bioglasses (20,24,34) to minimize the risk of infection. The antimicrobial efficacy of coatings containing ionic silver or elemental silver nanoparticles was shown in many studies.…”

Management of short‐term indwelling urethral catheters to prevent urinary tract infections

“…These studies found no clear benefit from using either preconnected sealed systems, or from the use of sealed systems with the addition of silver releasing devices. [28][29][30][31]33 One study found in favour of hydrophilic-coated silicone catheters, but the sample size was small, although these findings do suggest further research is warranted. 32…”

“…30 Subjects aged ≥18 and requiring continuous catheterisation were recruited from all medical and surgical specialties from a tertiary facility in Copenhagen. Exclusion criteria included existing UTI, onset of UTI within 48 h of recruitment to the study, and the presence of any concentration of microbes in their urine on day 1 of the study.…”