Efficacy of antimicrobial-impregnated bladder catheters in reducing catheter-associated bacteriuria: A prospective, randomized, multicenter clinical trial
Efficacy of antimicrobial-impregnated bladder catheters in reducing catheter-associated bacteriuria: A prospective, randomized, multicenter clinical trial
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DOI：
10.1016/s0090-4295(99)00288-5
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发表时间：
1999-12-01
期刊：
影响因子：
2.1
通讯作者：
Raad, II
中科院分区：
文献类型：
--
作者：
Darouiche, RO;Smith, JA;Raad, II
目标.探讨米诺环素和利福平浸渍膀胱导管在减少导管相关性菌尿中的疗效。方法.在五个学术医疗中心进行了一项前瞻性随机临床试验。接受根治性膀胱切除术的患者随机接受术中常规硅胶膀胱导管（对照导管）或浸渍米诺环素和利福平的硅胶膀胱导管（抗菌剂浸渍导管）。导管平均留置2周。在导管插入后约3、7和14天获得尿培养物。菌尿定义为尿液中微生物生长，浓度≥ 10（4）个菌落形成单位/ml。结果Kaplan-Meier分析表明，与接受对照导管的患者（n = 68）相比，接受抗菌剂浸渍导管的患者（n = 56）发生菌尿的时间显著更长（对数秩检验P = 0.006）。接受抗菌浸渍导管的患者在第7天的菌尿率均显著低于对照组（15.2% vs 39.7%）和第14天（58.5% vs 85.5%）导管插入后，与对照组相比，接受抗菌剂浸渍导管的患者的革兰氏阳性菌尿率显著降低（7.1%对38.2%; P < 0.001），但革兰氏阴性菌尿（46.4%对47.1%）和念珠菌尿（3.6%对2.9%）的发生率相似。抗菌剂浸渍的导管在基线和移除时均提供了对粪肠球菌和大肠杆菌的抑制区。结论.膀胱导管浸渍米诺环素和利福平显着降低率革兰氏阳性导管相关菌尿2周后，导管插入。(C)1999年，Elsevier Science Inc.
Objectives. To examine the efficacy of bladder catheters impregnated with minocycline and rifampin in reducing catheter-associated bacteriuria. Methods. A prospective, randomized clinical trial was conducted at five academic medical centers. Patients undergoing radical prostatectomy were randomized to receive intraoperatively either regular silicone bladder catheters (control catheters) or silicone bladder catheters impregnated with minocycline and rifampin (antimicrobial-impregnated catheters). Catheters remained in place for a mean of 2 weeks. Urine cultures were obtained at about 3, 7, and 14 days after catheter insertion. Bacteriuria was defined as the growth of organism(s) in urine at a concentration of 10(4) colony-forming units per milliliter or greater. Results. Kaplan-Meier analysis demonstrated that it took significantly longer for patients (n = 56) who received the antimicrobial-impregnated catheters to develop bacteriuria than those (n = 68) who received the control catheters (P = 0.006 by the log-rank test). Patients who received the antimicrobial-impregnated catheters had significantly lower rates of bacteriuria than those in the control group both at day 7 (15.2% versus 39.7%) and at day 14 (58.5% versus 85.5%) after catheter insertion, Patients who received the antimicrobial-impregnated catheters had significantly lower rates of gram-positive bacteriuria than the control group (7.1% versus 38.2%; P < 0.001) but similar rates of gram-negative bacteriuria (46.4% versus 47.1%) and candiduria (3.6% versus 2.9%). The antimicrobial-impregnated catheters provided zones of inhibition against Enterococcus faecalis and Escherichia coli, both at baseline and on removal. Conclusions. Bladder catheters impregnated with minocycline and rifampin significantly reduced the rate of gram-positive catheter-associated bacteriuria up to 2 weeks after catheter insertion. (C) 1999, Elsevier Science Inc.