Steriled and Nonsteriled Urinary Catheters and the Urinary Tract Infection in Hospitalized Patients

Abstract

Background:: Urinary tract infection (UTI) is one of the most common types of infection which can occur in all age groups. The use of catheters is one of the most important underlying factors, especially when they are left in place for a long time. Objectives:: This study aimed to investigate the effect of sterile catheter fixation on bacteriuria and urinary tract infections. Patients and Methods:: The present research is a clinical trial study. The patients who had urinary catheters based on the existing indications in 2012, hospitalized in Imam Hussein (AS) Hospital, Tehran enrolled in the study. Patients were divided into two groups. The first group consisted of patients whom the catheters were installed by a medical intern in the emergency department. The second group consisted of patients whom the catheters were installed in the same department by two medical interns using a completely sterile method especially at fixation and lubrication steps. The information contained in the patients' check list including the background information, age, hospitalization days, history of urinary catheters, history of infection and results of urine culture and analysis. Results:: A total of one hundred and eighty-eight individuals with the mean age of 39.1 ± 19 years (age range between 18 - 77 years old) enrolled in this study. There was no significant difference in the number of hospitalization days between the two groups (P > 0.05). The number of hospitalization days and incidence of infection were significantly correlated (P < 0.05). The results showed a total OR of 1.5 indicating that the risk of infection is higher in the first group. Overall, the rate of urinary tract infection in this study was 16.4% while this rate was 19.1% and 13.8% in the first and second groups, respectively. The statistical tests showed significant difference between two groups in the incidence of urinary tract infection (P < 0.05), and also positive urine cultures were reported for twelve patients in the first group and nine patients in the second group. Escherichia coli (E. coli) was the most common infective microorganism in both groups, which was observed in 66.6% of the first and 88.8% of the second groups. The frequency of Gram-negative bacteria was 10 cases (83.3%) in the first group and 8 cases (88.8%) in the second group. Conclusions:: According to this study, employing the principles of sterile techniques during the catheterization and sterilization of instruments, as well as skills and experiments of individuals in this process, are the most important factors that can significantly reduce the number of infections after catheterization.