Comparative Study of Bacterial Isolation and Antibiotic Sensitivity Test between Long-term Silicone and Nitrofurazone-coated Suprapubic Catheter Indwelling Patients / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Catheter-associated urinary tract infections are inevitable in patients with a long-term indwelling catheter. The antibacterial activity of nitrofurazone-impregnating compounds has recently been employed in urinary catheter, and may be effective in blocking infections. The aims of this study were to evaluate the bacterial isolation, antibiotic sensitivity test and the efficacy of a nitrofurazone-coated urinary catheter. MATERIALS AND METHODS: A total of 41 patients that required an indwelling urinary catheter for longer than 4 weeks were assigned to receive either a silicone (n=24), or nitrofurazone, coated catheter (n=17). Urine and catheter tip samples were cultured for bacteriological assessment. The results of the bacterial culture and antibiotic sensitivity test, rate of infection from urine and proximal tip were compared between the two groups. RESULTS: The bacterial cultures from the tips of the silicone and nitrofurazone catheters were in 95.8 and 82.4%, respectively, but were statistically insignificant (p=0.064). Bacteriuria developed in 79.2 and 64.7% of the silicone-coated and nitrofurazone-coated catheter groups (p=0.476). Gram negative bacteria were found in 65 (69.8%), with the most three frequent species being Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumonia in 23 (24.7%), 20 (21.5%) and 16 (17.2%), respectively. All the organisms were more susceptible to amikacin, aztreonam and ceftriaxone, but were relatively resistant to ampicillin, gentamycin and ciprofloxacin. CONCLUSIONS: Many of the patients with a long-term indwelling catheter had bacterial infections or colonization in the urine and proximal catheter-tip samples, despite the preventive administration of antibiotics. This study failed to demonstrate any efficacy of a nitrofurazone-coated catheter.