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      El catéter vesical Foley BIP es superior al Foley convencional en la reducción de las infecciones urinarias secundarias a catéter en pacientes hospitalizados Translated title: The BIP Foley catheter is superior to the conventional Foley catheter in reducing catheter-associated urinary tract infections in hospitalized patients

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          Abstract

          Resumen Introducción: La infección de tracto urinario asociada a catéter (ITUCV) es la causa más frecuente de infección asociada a los cuidados de la salud. Existen diversas estrategias para prevenir dichas infecciones. Se deben considerar nuevas estrategias como los catéteres vesicales BIP (catéteres con recubrimiento de plata, oro, paladio), como una alternativa para reducir las mismas. Objetivos: Comparar la incidencia de las ITUCV en pacientes con catéter vesical Foley BIP versus Foley convencional. Metodología: Se realizó un ensayo clínico con aleatorización simple, siguiendo el sistema de doble ciego. Se estableció un nivel de confianza del 95%, un error no mayor del 5%. Obteniendo un total de 140 casos, alcanzando así una muestra representativa. Resultados: 140 casos con una inclusión de 125 casos y una exclusión de 15 casos (11%). La media de edad fue 50 años ± 18, con un 52 % hombres y 48% mujeres. El tiempo observado promedio fue de 10 días ± 7. Se presentó una tasa de incidencia global de 25 ITUCV x 1000 días. Discusión: El uso del catéter urinario Foley es una práctica cotidiana. El uso de catéteres Foley BIP disminuyó la tasa de incidencia de infección de vías urinarias asociada a catéter. Conclusiones: Las ITUCV son la infección más frecuente asociado a cuidados de la salud. Las infecciones nosocomiales representan un indicador de calidad de atención de los pacientes, repercuten en la morbimortalidad y economía de los pacientes. Los catéteres con recubrimiento fueron una medida eficaz, disminuyendo de manera considerable la incidencia de ITUCV.

          Translated abstract

          Abstract Background: Catheter-associated urinary tract infections (CAUTIs) are the most frequent cause of infection related to healthcare. There are different strategies for preventing them and new ones, such as BIP Foley catheters (catheters coated in silver, gold, and palladium), should be considered as an alternative in reducing said infections. Aims: To compare the incidence of CAUTIs in patients with BIP Foley catheters versus conventional Foley catheters. Materials and methods: A double-blind clinical trial with simple randomization was conducted, obtaining a representative sample of 140 cases. A 95% confidence interval and error not greater than 5% were established. Results: Of the 140 cases, 15 were excluded (11%), leaving a total of 125 cases. Mean patient age was 50 years ± 18; 52% were men and 48% were women. Mean time observed was 10 days ± 7. Overall incidence was 25 CAUTIs x 1000 days. Discussion: Foley catheter use is an everyday practice. BIP Foley catheters reduce the incidence of CAUTIs. Conclusions: CAUTIs are the most frequent infections associated with healthcare. Nosocomial infections are an indicator of the quality of patient care, negatively impacting morbidity and mortality, as well as patient economy. The use of coated catheters was an efficacious measure that considerably reduced the incidence of CAUTIs.

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          Infection control - a problem for patient safety.

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            Antimicrobial catheters for reduction of symptomatic urinary tract infection in adults requiring short-term catheterisation in hospital: a multicentre randomised controlled trial.

            Catheter-associated urinary tract infection (CAUTI) is a major preventable cause of harm for patients in hospital. We aimed to establish whether short-term routine use of antimicrobial catheters reduced risk of CAUTI compared with standard polytetrafluoroethylene (PTFE) catheterisation. In our parallel, three group, multicentre, randomised controlled superiority trial, we enrolled adults (aged ≥16 years) requiring short-term (≤14 days) catheterisation at 24 hospitals in the UK. Participants were randomly allocated 1:1:1 with a remote computer allocation to receive a silver alloy-coated catheter, a nitrofural-impregnated catheter, or a PTFE-coated catheter (control group). Patients undergoing unplanned catheterisation were also included and consent for participation was obtained retrospectively. Participants and trial staff were unmasked to treatment assignment. Data were collected by trial staff and by patient-reported questionnaires for 6 weeks after randomisation. The primary outcome was incidence of symptomatic urinary tract infection for which an antibiotic was prescribed by 6 weeks. We postulated that a 3·3% absolute reduction in CAUTI would represent sufficient benefit to recommend routine use of antimicrobial catheters. This study is registered, number ISRCTN75198618. 708 (10%) of 7102 randomly allocated participants were not catheterised, did not confirm consent, or withdrew, and were not included in the primary analyses. Compared with 271 (12·6%) of 2144 participants in the control group, 263 (12·5%) of 2097 participants allocated a silver alloy catheter had the primary outcome (difference -0·1% [95% CI -2·4 to 2·2]), as did 228 (10·6%) of 2153 participants allocated a nitrofural catheter (-2·1% [-4·2 to 0·1]). Rates of catheter-related discomfort were higher in the nitrofural group than they were in the other groups. Silver alloy-coated catheters were not effective for reduction of incidence of symptomatic CAUTI. The reduction we noted in CAUTI associated with nitrofural-impregnated catheters was less than that regarded as clinically important. Routine use of antimicrobial-impregnated catheters is not supported by this trial. UK National Institute for Health Research Health Technology Assessment Programme. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              A randomized crossover study of silver-coated urinary catheters in hospitalized patients.

              Urinary tract infections (UTIs) account for 30% to 40% of nosocomial infections resulting in morbidity, mortality, and increased length of hospital stay. To assess the efficacy of a silver-alloy, hydrogel-coated latex urinary catheter for the prevention of nosocomial catheter-associated UTIs. A 12-month randomized crossover trial compared rates of nosocomial catheter-associated UTI in patients with silver-coated and uncoated catheters. A cost analysis was conducted. There were 343 infections among 27,878 patients (1.23 infections per 100 patients) during 114,368 patient-days (3.00 infections per 1000 patient-days). The relative risk of infection per 1000 patient-days was 0.79 (95% confidence interval, 0.63-0.99; P =.04) for study wards randomized to silver-coated catheters compared with those randomized to uncoated catheters. Infections occurred in 291 of 11,032 catheters used on study units (2.64 infections per 100 catheters). The relative risk of infection per 100 silver-coated catheters used on study wards compared with uncoated catheters was 0.68 (95% confidence interval, 0.54-0.86; P =.001). Fourteen catheter-associated UTIs (4.1%) were complicated by secondary bloodstream infection. One death appeared related to the secondary infection. Estimated hospital cost savings with the use of the silver-coated catheters ranged from $14,456 to $573,293. The risk of infection declined by 21% among study wards randomized to silver-coated catheters and by 32% among patients in whom silver-coated catheters were used on the wards. Use of the more expensive silver-coated catheter appeared to offer cost savings by preventing excess hospital costs from nosocomial UTI associated with catheter use. Arch Intern Med. 2000;160:3294-3298.
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                Author and article information

                Journal
                rmu
                Revista mexicana de urología
                Rev. mex. urol.
                Sociedad Mexicana de Urología (Ciudad de México, Ciudad de México, Mexico )
                0185-4542
                2007-4085
                April 2020
                : 80
                : 2
                : e04
                Affiliations
                [1] Ciudad de México orgnameSecretaría de Salud orgdiv1Hospital General de México “Dr. Eduardo Liceaga” México
                [4] Ciudad de México orgnameHospital HMG Coyoacán México
                [2] Ciudad de México orgnameHospital Ángeles Metropolitano México
                [3] Ciudad de México orgnameSecretaría de Salud orgdiv1Hospital General “Dr. Manuel Gea González” Mexico
                Article
                S2007-40852020000200004 S2007-4085(20)08000200004
                10.48193/rmu.v80i2.594
                bd3defa4-942d-492b-b7a4-0e8b86eeee3f

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 07 April 2020
                : 21 January 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 12, Pages: 0
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                SciELO Mexico

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                Artículos originales

                sondas urinarias,Catheter-associated urinary infection,comparación,urinary catheters,comparison,Infección urinaria asociada a catéter

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