CLINICAL-TRIAL OF JUNCTION SEALS FOR THE PREVENTION OF URINARY CATHETER ASSOCIATED BACTERIURIA
CLINICAL-TRIAL OF JUNCTION SEALS FOR THE PREVENTION OF URINARY CATHETER ASSOCIATED BACTERIURIA
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DOI：
10.1001/archinte.152.4.807
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发表时间：
1992-04-01
影响因子：
--
通讯作者：
STEVENS, LE
中科院分区：
文献类型：
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作者：
HUTH, TS;BURKE, JP;STEVENS, LE
背景- 具有密封接头的预连接导管系统与菌尿率和死亡率降低相关。进行了一项临床试验，以评估导管插入后应用连接密封预防菌尿和降低死亡率的有效性。- 在社区医院接受经尿道导管插入术的患者在导管插入后24小时内随机接受导管-引流管连接处的胶带密封或无胶带密封。每天监测导尿管尿培养和导尿管护理违规情况，直至拔除导尿管或患者出院。- 总体而言，接受接合密封的903例患者中有124例（13.7%）获得了菌尿，而对照组837例患者中有125例（14.9%）获得了菌尿（P = 0.52，比值比= 0.91，95%置信区间，0.69 - 1.20）。多变量分析显示，只有女性和缺乏全身抗生素使用与菌尿的发展独立相关;交界处治疗随机化和交界处断开均与菌尿无关。按性别和抗生素使用分层的患者生存曲线分析显示，治疗组之间菌尿率无显著差异。胶带密封组的总体死亡率低于对照组（分别为6.6%和8.0%），但尽管按抗生素使用分层，但差异无统计学意义。- 在导管插入后24小时内，在导管-引流管连接处使用胶带密封与接受短期导管插入术的患者的菌尿率和死亡率显著降低无关。
Background. - Preconnected catheter systems with sealed junctions have been associated with reduced rates of bacteriuria and mortality. A clinical trial was undertaken to evaluate the effectiveness of a junction seal applied after catheter insertion for preventing bacteriuria and reducing mortality.Methods. - Patients undergoing transurethral catheterization at a community hospital were randomized within 24 hours of catheter insertion to receive either a tape seal applied to the catheter-drainage tubing junction or no tape seal. Catheter urine cultures and catheter care violations were monitored daily until catheter removal or patient discharge.Results. - Overall, 124 (13.7%) of 903 patients in the group receiving a junction seal acquired bacteriuria, compared with 125 (14.9%) of 837 patients in the control group (P = .52, odds ratio = 0.91, 95% confidence interval, 0.69 to 1.20). Multivariate analysis revealed that only female gender and lack of systemic antibiotic use independently correlated with the development of bacteriuria; neither junction treatment randomization nor disconnection of the junction was associated with bacteriuria. Survival curve analysis of patients stratified by gender and antibiotic use revealed no significant differences in the rate of bacteriuria between treatment groups. The overall mortality in the tape seal group was less than that in the control group (6.6% vs. 8.0%, respectively), but not to a statistically significant extent despite stratification by antibiotic use.Conclusions. - The use of a tape seal applied to the catheter-drainage tubing junction within 24 hours of catheter insertion was not associated with significantly lower rates of bacteriuria and mortality in patients undergoing short-term catheterization.