Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters

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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.Spinal Cord advance online publication, 25 November 2014; doi:10.1038/sc.2014.210.

Original languageEnglish
JournalSpinal Cord
DOIs
Publication statusAccepted/In press - 25 Nov 2014

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Intermittent Urethral Catheterization
Bacteriuria
Urinary Tract Infections
Catheters
Neurogenic Urinary Bladder
Urine
Specimen Handling
Malaysia
Incidence
Tertiary Healthcare
Tertiary Care Centers
Cross-Over Studies
Publications
Spinal Cord
Stem Cells

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

@article{240419d1578d4c30b0a134aeadcdc49a,
title = "Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters",
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.Spinal Cord advance online publication, 25 November 2014; doi:10.1038/sc.2014.210.",
author = "{P. Yoganathan}, Kanaheswari and R. Kavitha and {Abdul Manaf}, {Mohd Rizal}",
year = "2014",
month = "11",
day = "25",
doi = "10.1038/sc.2014.210",
language = "English",
journal = "Spinal Cord",
issn = "1362-4393",
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T1 - Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters

AU - P. Yoganathan, Kanaheswari

AU - Kavitha, R.

AU - Abdul Manaf, Mohd Rizal

PY - 2014/11/25

Y1 - 2014/11/25

N2 - 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.Spinal Cord advance online publication, 25 November 2014; doi:10.1038/sc.2014.210.

AB - 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.Spinal Cord advance online publication, 25 November 2014; doi:10.1038/sc.2014.210.

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