Implementing infection prevention technology

Urinary catheterisation is an essential part of modern healthcare. However, this procedure is associated with increased infection risk. Catheter-Associated Urinary Tract Infections (CAUTIs) are one of the most common nosocomial infections in hospitals,1 while the risk of developing bacteriuria is around 3% to 6% per catheter-day.2 The major risk factor for CAUTI is the presence of a urinary catheter for more than six days, which increases the risk more than six-fold.3 Around half of patients who are catheterised for more than 7 to 10 days contract bacteriuria1 and 55% of urinary infections are related to the presence of an indwelling catheter.4 Although catheter-associated bacteriuria is often asymptomatic, 20% to 30% of these patients will go on to exhibit symptoms of CAUTI. These infections can be serious and are associated with significant morbidity and mortality; 1% to 4% of CAUTI patients develop bacteraemia, which is fatal in up to 30% of cases.1 Contraction of a CAUTI has been estimated to result in patients spending up to six additional days in hospital5 and although a UTI is the least expensive nosocomial infection, with an estimated additional cost of £1,327 per patient,5 the high incidence of this class of infection renders it the most expensive single-site infection nationally, with an estimated annual cost of £124 million.6

Role of silver alloy coating in catheters

Bacteria on the surfaces of urinary catheters rapidly form biofilms which are extremely resistant to antibiotic therapy. Infected urinary catheters are typically covered with a thick film of the infecting microorganisms and adherence of these microbes to catheter surfaces plays an important role in CAUTI pathogenesis.3 Silver has long-established antibacterial properties and is already used in medical dressings. In vitro adhesion of both Grampositive and Gram-negative bacteria to silver alloy-coated hydrogel catheter surfaces has been shown to be significantly reduced in comparison to the surfaces of all silicone catheters.7 A two-year prospective surveillance study of 10 patient care units using silver alloy hydrogel-coated urinary catheters demonstrated a significant decrease in CAUTIs, with no silver-resistant urinary pathogens recovered from CAUTI patients.8