Comparison of a Metal-Alloy Impregnated Urinary Catheter and Conventional Latex Foley Catheter for Preventing UTI in Critically Ill Trauma ICU Admitted Patients: A Prospective, Randomized Clinical Trial

Author(s): Priya Singla, Badri Prasad Das, Munesh Kumar Gupta, Matendra Singh Yadav, Sradha Choudhury, GK Sinha

Objectives: Urinary tract infection (UTI) is the most common health-care associated infection worldwide, where the quality of Foley catheter and duration affects its occurrence. Apart from conventional Foley catheters, metal-alloy impregnated catheters (BIP Foley catheters) are also being increasingly used for urinary catheterization in ICU patients.

Material and Methods: This single-centric, prospective, single-blinded, randomized, clinical comparative study was conducted from September 2019 to August 2020 in Trauma-ICU, Department of Anesthesiology, IMS-BHU, where patients with trauma aged 18-60 years, requiring urinary catheterisation for at least 3 days, were allocated into one of the 2 study groups based on the Foley catheters used (Group A: Conventional latex Foley Catheter or Group B: BIP Foley catheter). We noted incidence of nosocomial UTI (bacterial/ fungal) in form of symptomatic CAUTI (S-CAUTI) and catheter?associated asymptomatic bacteriuria (CA?ASB) as primary outcome, while clinical outcome in form of 30-day mortality was assessed as secondary outcome. Chi-Square/ Student’s t-test were used for qualitative/ quantitative data with statistical significance at p-value ≤ 0.05.

Results: We noted comparable demographic parameters. Out of 79 analyzed patients in group A, 16 patients developed S-CAUTI as compared to 4 out of 74 analyzed patients in group B (p<0.006). Most common bacteria isolated in S-CAUTI was Escherichia coli (15.2% in group A and 4.1% in group B) followed by Enterococcus (2.5% in group A and 1.4% in group B). The relative risk reduction in group B was 48.3% as compared to group A.

Conclusion: Use of metal-alloy impregnated urinary catheter (BIP) for catheterizing critically ill patients had resulted in lower incidence of CAUTI in Trauma-ICU admitted patients, however without any significant mortality benefit.