Comparison Study of Home Catheter Cleaning Methods

Abstract

Three methods of cleaning urinary catheters for reuse at home by clients on intermittent catheterization programs were studied. Reused catheters were collected from clients, autoclaved, and then incubated in a culture of Escherichia coli broth. Three different isolates of E. coli were used at concentrations ranging from 4.8 x 10(5) to 1.0 x 10(8) colony-forming units per milliliter. The catheters were then rinsed with tap water for 1 minute and soaked in one of three cleaning solutions for 30 minutes. The three cleaning solutions studied were 0.6% hydrogen peroxide, bleach in a 1:4 solution with tap water, and betadine in a 1:2 solution with tap water. None of the cleaned catheters showed detectable growth for 48 hours after the cleaning procedure was performed.

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

“…Nevertheless, several procedures have been evaluated and have been shown to reduce bacterial contamination of reusable catheters, including rinsing catheters with running tap water after every use, air-drying, and keeping the catheters dry until reuse [174]; microwaving catheters [175][176][177][178]; and soaking catheters in hydrogen peroxide, bleach, or betadine [179]. However, there are no published trials evaluating the effectiveness of any of these cleaning methods in preventing CA-bacteriuria or CA-UTI among patients with intermittent catheterization.…”

An effective evidence‐based cleaning method for the safe reuse of intermittent urinary catheters: In vitro testing

“…Both bacteria and chemical agents will respond differently in varying environmental conditions, and it is essential that any in vitro study reflects real conditions as accurately as possible. Previous studies, such as Kurtz et al, 12 have used standard broth media, which could result in very different responses from the E. coli or indeed affect the activity of the bleach solution they tested. In this study, the use of two artificial urine media strengthens the validity of the current study, with one representing a “‘healthy” urine 18 and the other, a “diseased” urine, 19 two conditions likely to be reflected in ISC users who are all likely to have asymptomatic bacteriuria but not necessarily UTIs.…”

“…Both bacteria and chemical agents will respond differently in varying environmental conditions, and it is essential that any in vitro study reflects real conditions as accurately as possible. Previous studies, such as Kurtz et al, 12 F I G U R E 3 Episcopic differential interference contrast microscopy images of uncoated PVC catheters pre-and postbacterial exposure and subsequent decontamination. A, Unused PVC catheter surface before bacterial exposure and decontamination.…”

“…5 Moreover, recent advances in next-generation sequencing indicate that a urinary microbiome exists, in contrast to previous assertions that the bladder is sterile. 6 Various methods of decontamination have been evaluated previously including microwave, 7-10 boiling, 11 bleach, 12 detergent and water, 10,[13][14][15] hydrogen peroxide, 12 povidone-iodine, 12,14 vinegar, 14 and storage in alcohol. 9 Each method demonstrated some efficacy but all the studies had limitations including the use of microbiological techniques limited to reliance on culture analysis only and/or use of nutrient broth rather than artificial urine media.…”

Inhaled medication and inhalation devices for lung disease in patients with cystic fibrosis: A European consensus

“…A low risk of microbial contamination of CF inpatients with CF pathogens from the interior of a disposable nebuliser over a 24 h period was reported [222]. Also, the bacterial flora from environmental sources, for example from tap water [219,223,224] may contaminate a nebuliser, as well as the colonising flora of the oropharynx [213]. Importantly, nebuliser devices should not be shared between CF patients as this has been associated with the acquisition of B. cepacia complex strains [225].…”