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.
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Acknowledgements
The authors acknowledge the following collaborators: Dr Ramliza Ramli and Assoc Prof SW Wong of the Universiti Kebangsaan Malaysia Medical Centre; Drs YN Lim, YC Yap and Susan Woo of the Institute Paediatrics Hospital Kuala Lumpur for their assistance in this study; and Prof LC Ong for her advice and guidance during the development of the study protocol. The study was sponsored by Universiti approved research study grant.
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Kanaheswari, Y., Kavitha, R. & Rizal, A. Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters. Spinal Cord 53, 209–212 (2015). https://doi.org/10.1038/sc.2014.210
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DOI: https://doi.org/10.1038/sc.2014.210
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