查看更多>>摘要：Background:A new type of silver alloy hydrogel-coated(SAH)catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent,and to block the retrograde infection pathway.However,these have only been confirmed in ordinary patients.This study aims to evaluate the effectiveness of a SAH catheter for preventing urinary tract infections in critically ill patients.Methods:This was a prospective single-center,single-blind,randomized,controlled study.A total of 132 patients requiring indwelling catheterization in the intensive care unit(ICU)of the First Affiliated Hospital of the Uni-versity of Science and Technology of China between October 2022 and February 2023 and who met the study inclusion/exclusion criteria were randomly divided into two groups.Patients in the SAH catheter group received a SAH catheter,while patients in the conventional catheter group received a conventional siliconized latex Foley catheter.The main outcome measure was the incidence of catheter-associated urinary tract infections(CAUTIs).Secondary outcome indicators included urine positivity for white blood cells and positive urine cultures on 3 days,7 days,10 days,and 14 days after catheterization,number of viable bacteria in the catheter biofilm on day 14,pathogenic characteristics of positive urine cultures,length of ICU stay,overall hospital stay,ICU mortality,and 28-day mortality.All the data were compared between the two groups.Results:A total of 68 patients in the conventional catheter group and 64 patients in the SAH catheter group were included in the study.On day 7 after catheter placement,the positivity rate for urinary white blood cells was significantly higher in the conventional catheter group than in the SAH catheter group(33.8％vs.15.6％,P=0.016).On day 10,the rates of positive urine cultures(27.9％vs.10.9％,P=0.014)and CAUTIs(22.1％vs.7.8％,P=0.023)were significantly higher in the conventional catheter group than in the SAH catheter group.On day 14,the numbers of viable bacteria isolated from the catheter tip([3.21±1.91]x106 colony-forming units[cfu]/mL vs.[7.44±2.22]×104 cfu/mL,P＜0.001),balloon segment([7.30±1.99]×107 cfu/mL vs.[3.48±2.38]×105 cfu/mL,P＜0.001),and tail section([6.41±2.07]×105 cfu/mL vs.[8.50±1.46]×103 cfu/mL,P＜0.001)were significantly higher in the conventional catheter group than in the SAH catheter group.The most common bacteria in the urine of patients in both groups were Escherichia coli(n=13)and Pseudomonas aeruginosa(n=6),with only one case of Candida in each group.There were no significant differences between the two groups in terms of ICU hospitalization time,total hospitalization time,ICU mortality,and 28-day mortality.Conclusion:SAH catheters can effectively inhibit the formation of catheter-related bacterial biofilms in critically ill patients and reduce the incidence of CAUTIs,compared with conventional siliconized latex Foley catheters;however,regular replacement of the catheter is still necessary.
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