Catheter-associated bacteriuria. Failure to reduce attack rates using periodic instillations of a disinfectant into urinary drainage systems

Abstract

The efficacy of periodic instillations of H2O2 into urinary drainage systems in the prevention of catheter-associated bacteriura was assessed in a prospective and randomized clinical study of 668 patients with indwelling urethral catheters. Bacteriuria was documented in 68 (10%) of the 668 patients after a mean duration of 4 days of catheterization. There was no difference between the H2O2 group and the control group in the mean duration of catheterization before the onset of bacteriuria, in the attack rate for bacteriuria or in the spectrum of etiologic agents recovered. Bag contamination with the same organism responsible for bacteriuria preceded infection in only 5 (7%) of the 68 patients, 3 patients using H2O2 and 2 in the control group. Thus, infections arising intraluminally from contamination of the drainage bag are uncommon among catheterized patients; the periodic instillation of disinfectants into closed sterile drainage systems is not effective in reducing the incidence of catheter-associated bacteriuria.