Most patients go into the hospital, get better and go home. Unfortunately, about 5 to 10 percent of patients in the United States develop an infection while hospitalized, which can result in a longer hospital stay, increased costs, and in some cases, death.
Each year, about 25 percent of the estimated 40 million people hospitalized receive urinary catheters. Though necessary, catheters also can introduce bacteria into the bladder and cause infection. About 1 million people a year contract urinary tract infections (UTIs) due to catheters, said Mark Rupp, M.D., UNMC professor of internal medicine/infectious diseases and director of the Department of Healthcare Epidemiology at The Nebraska Medical Center.
In an attempt to reduce infections caused by urinary catheters, Dr. Rupp and colleagues conducted a two-year study in 10 patient care units at The Nebraska Medical Center. The objective was to determine the effectiveness of a new silver alloy, hydrogel-coated urinary catheter in reducing the rate of UTIs.
The study found the catheters reduced UTIs by 57 percent during the two-year follow-up. The results were published recently in the American Journal of Infection Control.
In the United States, UTIs account for up to 40 percent of hospital-acquired infections, are complicated by bacteria in the bloodstream in about 4 percent of cases, and result nationally in $500 million of increased hospital costs annually, Dr. Rupp said. For each day a catheter remains in the bladder, there is a 5 percent risk of contracting UTIs, he said.
“Our study showed that use of the coated catheters prevented about half of the infections, saved money, prevented complications associated with treatment, and probably had other benefits that weren’t directly measured in the study such as improved patient satisfaction, decreased length of hospital stay, and decreased antibiotic resistance,” Dr. Rupp said.
Although most are easily treated, in rare cases the infection spreads out of control and can cause death – an estimated 1,000 deaths a year across the country, Dr. Rupp said.
Researchers say the catheter works better because the silver alloy is noxious to bacteria but doesn’t have toxic effects on the urinary tract.
“A growing body of literature supports their use in a variety of clinical settings and we were pleased to be able to advance our knowledge of how to best prevent these important infections,” said Theresa Fitzgerald, nurse and infection control specialist, The Nebraska Medical Center.
The Nebraska Medical Center uses the silver alloy catheters throughout the system as the standard urinary catheter. “We are all interested in making our hospitals safer,” Dr. Rupp said. “This is one way to cut the infection rate in half and prevent the treatment costs associated with the infection. Despite the increased cost of the coated catheter, by preventing over 50 percent of UTIs, it’s estimated that the hospital saves about $70,000 a year.”
Paul Fey, Ph.D., a UNMC microbiologist and co-author of the paper, tested the bacteria that caused UTIs in patients despite using the silver alloy catheters. “Some patients with these catheters still get UTIs, but we found out it’s not due to the bacteria developing resistance to the silver alloy. We need to continue to seek improvements in the catheters that may prevent even more of these infections,” Dr. Fey said.
Nedra Marion, nurse and manager of the Department of Healthcare Epidemiology at The Nebraska Medical Center, said care also can be further improved by promptly removing catheters when they are no longer needed.