Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters - Abstract

Study design: This study was designed as a comparative cross-sectional cross-over trial on children performing clean intermittent catheterization (CIC) with reused catheters for 1 or 3 weeks.

Objectives: To determine the incidence of symptomatic urinary tract infection (UTI) and bacteriuria (defined as colony count of ⩾105 colony forming units per ml of a single strain of organism) in these two different frequencies of catheter change.

Setting: Multidisciplinary children's neurogenic bladder clinics at two tertiary care hospitals in Kuala Lumpur Malaysia.

Methods: Forty children aged between 2 and 16 years performing CIC for at last 3 years were recruited. Medical and social data were obtained from case files. Baseline urine cultures were taken. All children changed CIC catheters once in 3 week for the first 9 weeks followed by once a week for the next 9 weeks. Three-weekly urine cultures were obtained throughout the study. Standardization of specimen collection, retrieval and culture was ensured between the two centers.

Results: At baseline, 65% of children had bacteriuria. This prevalence rose to 74% during the 3-weekly catheter change and dropped to 34% during the weekly catheter change (Z-score 6.218; P<0.001). Persistence of bacteriuria (all three specimens in each 9-week period) changed significantly from 60 to 12.5%, respectively (P<0.005). There was no episode of UTI during the 18-week study period.

Conclusion: Reuse of CIC catheters for up to 3 weeks in children with neurogenic bladders appears to increase the prevalence of bacteriuria but does not increase the incidence of symptomatic UTI.

Click HERE to listen to Diane Newman, DNP, ANP-BC, FAAN discuss this study

Written by:
Kanaheswari Y,1 Kavitha R,2 Rizal AM,3   Are you the author?
1Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
2Department of Paediatrics, Hospital Sulltanah Bahiyah, Alor Setar, Malaysia.
3Department of Community Health, Universiti Kebangsaan Medical Centre, Kuala Lumpur, Malaysia.

Reference: Spinal Cord. 2014 Nov 25. (Epub ahead of print)
doi: 10.1038/sc.2014.210

PubMed Abstract
PMID: 25420498