A Prospective Trial of a Novel, Silicone-Based, Silver-Coated Foley Catheter for the Prevention of Nosocomial Urinary Tract Infections

Srinivasan, Arjun; Karchmer, Tobi B.; Richards, Ann; Song, Qinbao; Perl, Trish M.

doi:10.1086/499998

Cited by 102 publications

(57 citation statements)

References 37 publications

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“…The positive results of these earlier studies made routine use of silver-coated megaprostheses possible in our department. Since negative results with silver-coated devices have also been reported in the literature [10,11,25], it was desirable to present early results with the new prosthesis in order to avoid potential errors. Schierholz et al [26] have raised concerns that free silver ions may precipitate in albumin-containing environments (e.g., hematoma), leading to concentrations that are too low for bactericidal effects to be achieved.…”

Section: Discussionmentioning

confidence: 99%

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Reduction of periprosthetic infection with silver‐coated megaprostheses in patients with bone sarcoma

Hardes

Eiff

Streitbuerger

et al. 2010

Journal of Surgical Oncology

305

225

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Background and Objectives: The placement of megaprostheses in patients with bone sarcoma is associated with high rates of infection, despite prophylactic antibiotic administration. In individual cases, secondary amputation is unavoidable in the effort to cure infection. Methods: The infection rate in 51 patients with sarcoma (proximal femur, n ¼ 22; proximal tibia, n ¼ 29) who underwent placement of a silver-coated megaprosthesis was assessed prospectively over a 5-year period, along with the treatment administered for infection. The infection rate was compared with the data for 74 patients in whom an uncoated titanium megaprosthesis (proximal femur, n ¼ 33; proximal tibia, n ¼ 41) was implanted. Results: The infection rate was substantially reduced from 17.6% in the titanium to 5.9% in the silver group. Whereas 38.5% of patients in the titanium group ultimately had to undergo amputation when periprosthetic infection developed, these mutilating surgical procedures were not necessary in the study group. Conclusions: The use of silver-coated prostheses reduced the infection rate in the medium term. In addition, less aggressive treatment of infection was possible in the group with silver-coated prostheses. Further studies with longer term follow-up periods and larger numbers of patients are warranted in order to confirm these encouraging results.

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Section: Discussionmentioning

confidence: 99%

“…However, recruitment in patients with tumor endoprostheses takes more time in comparison with patients with silver-coated urinary or central venous catheters, for example [22][23][24][25]. In addition to the aim of reducing infections, another aim is to treat these infections successfully without relevant morbidity.…”

Section: Discussionmentioning

confidence: 99%

Reduction of periprosthetic infection with silver‐coated megaprostheses in patients with bone sarcoma

Hardes

Eiff

Streitbuerger

et al. 2010

Journal of Surgical Oncology

305

225

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“…[11][12][13][14] In the field of orthopedics, there are multiple publications about silver-coatings of implants or pins for external fixation. [15][16][17][18][19] Even the use of silver in bone cement has been reported previously in the literature.…”

mentioning

confidence: 99%

No efficacy of silver bone cement in the prevention of methicillin‐sensitive Staphylococcal infections in a rabbit contaminated implant bed model

Moojen

Charles

Fleer

et al. 2009

Journal Orthopaedic Research

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Data from literature showed that a new type of metallic silver PMMA cement had good results in infection prophylaxis. This study investigated the in vivo efficacy of silver cement in the prevention of methicillin-sensitive Staphylococcal infections, compared to plain and tobramycin-containing cement. In 48 rabbits, 0.6% silver, 1% silver, plain, or tobramycin PMMA cement was injected into the femoral medullary canal after contamination with 10 5 , 10 6 , or 10 7 colony forming units (CFU) Staphylococcus aureus. After 14 days, bone was collected for bacteriology and histopathology. All plain and silver cement rabbits were infected, whereas only two tobra rabbits were infected (p < 0.001). The number of bacteria cultured ( 10 logCFU) from bone adjacent to the cement, was 6.4 AE 0.3 and 6.1 AE 0.3 for the 0.6% and 1% silver rabbits. For the rabbits with plain and tobra cement, this was 6.2 AE 0.2 (p > 0.95) and 0.0 AE 0.0 (p < 0.001), respectively. Two tobra rabbits had a positive culture of a distal bone sample. Histological sections of plain, 0.6%, and 1% silver rabbits all showed signs of infection; these signs were absent in the tobra rabbits. Silver and plain cement were not effective in preventing infection, whereas tobra cement was effective. As silver cement predominantly exhibits an antimicrobial effect at the direct cement surface, this cement seems less useful in situations where there are bacteria present in surrounding tissues, like revision surgery. Whether silver cement has relevance in the prevention of bacterial colonization of cement remains to be determined. ß

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“…Residents with chronic catheters have a decreased frequency of obstruction with silicone catheters, but this observation is attributed to the larger bore size of the catheter, rather than the catheter material. The use of silver alloy coated catheters does not decrease the frequency of CA-UTI [12,[61][62][63]. Nitrofurazone coated catheters have been reported to be associated with a small decrease in CA-UTI [12], but are accompanied by more frequent catheter removal and increased catheter discomfort.…”

Section: Selection Of Urinary Cathetermentioning

confidence: 95%

Catheter-associated urinary tract infections

2005

Advances in Small Animal Medicine and Surgery

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Urinary tract infection attributed to the use of an indwelling urinary catheter is one of the most common infections acquired by patients in health care facilities. As biofilm ultimately develops on all of these devices, the major determinant for development of bacteriuria is duration of catheterization. While the proportion of bacteriuric subjects who develop symptomatic infection is low, the high frequency of use of indwelling urinary catheters means there is a substantial burden attributable to these infections. Catheter-acquired urinary infection is the source for about 20% of episodes of health-care acquired bacteremia in acute care facilities, and over 50% in long term care facilities. The most important interventions to prevent bacteriuria and infection are to limit indwelling catheter use and, when catheter use is necessary, to discontinue the catheter as soon as clinically feasible. Infection control programs in health care facilities must implement and monitor strategies to limit catheter-acquired urinary infection, including surveillance of catheter use, appropriateness of catheter indications, and complications. Ultimately, prevention of these infections will require technical advances in catheter materials which prevent biofilm formation.

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A Prospective Trial of a Novel, Silicone-Based, Silver-Coated Foley Catheter for the Prevention of Nosocomial Urinary Tract Infections

Cited by 102 publications

References 37 publications

Reduction of periprosthetic infection with silver‐coated megaprostheses in patients with bone sarcoma

Reduction of periprosthetic infection with silver‐coated megaprostheses in patients with bone sarcoma

No efficacy of silver bone cement in the prevention of methicillin‐sensitive Staphylococcal infections in a rabbit contaminated implant bed model

Catheter-associated urinary tract infections

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