Abstract
Standardization of urinary catheter use is important to prevent symptomatic urinary tract (SUTI) infection in patients with acute neurological deficits. Also, the effect of sanitation on intermittent urinary drainage is unknown. We evaluated our algorithm for urinary catheter use, and abolition of sanitation on intermittent urinary drainage for the prevention of SUTI. Two historical controlled trials were performed in patients with neurological deficits. The incidence of SUTI was compared between two groups before and after introduction of the algorithm for urinary catheter use (Trial 1). The incidence of SUTI was compared between two groups with or without sanitation on intermittent urinary drainage (Trial 2). Trial 1 showed urinary catheter use increased from 10.4 to 12.8/100 patient days (p<0.001), but the incidence of SUTI decreased from 5.5 to 4.1/1000 patient days (p=0.275) after introduction of the algorithm for urinary catheter use. Trial 2 showed the incidence of SUTI was not significantly smaller in patients with sanitation (30 of 135 cases, 22 %) than without (13 of 50 cases, 26%).
Our two management protocols for the prevention of SUTI for patients with neurological deficits, algorithm for urinary catheter use and abolition of sanitation on intermittent urinary drainage, may be useful for prevention of SUTI. Prevention of SUTI in patients with neurological deficits, especially management of the urinary catheter and drainage, should be varied according to the individual characteristics.
