Pilot Study of a Non-Return Catheter Valve for
Reducing Catheter-Associated Urinary Tract
Infections in Critically Ill Patients
Anupol Panitchote MD*, Suranut Charoensri MD**,
Ploenchan Chetchotisakd MD***, Cameron Hurst PhD****
Affiliation :
* Division of Critical Care, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
** Division of Endocrinology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
*** Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand
**** Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : To determine the effectiveness of a non-return catheter valve vs. the standard urine bag for prevention of
catheter-associated urinary tract infections (CAUTI) in critically ill patients.
Material and Method: This was a pilot, randomized, stratified, open-label controlled trial (ClinicalTrials.gov, number
NCT01963013). Ninety-six critically ill patients requiring indwelling urinary catheter were assigned with either a non-return
catheter valve or the standard urine bag. Symptoms and signs of CAUTI before and after enrollment for all patients were
recorded. If CAUTI was suspected, urine for microbiological testing was collected. The primary outcome was the incidence
density rate of symptomatic CAUTI and bacteriurial presence.
Results : The 96 patients were randomized into two groups. Baseline patient characteristics were similar in both groups
except for the sex distribution. The incidence rate ratio was 0.71 for symptomatic CAUTI in the non-return catheter valve
group (95% CI 0.25-1.98, p-value = 0.51). The crude incidence rate ratio of bacteriuria in the non-return valve group was
0.66 (95% CI 0.3-1.46, p-value = 0.31). The sex-adjusted incidence rate ratio of bacteriuria in the non-return catheter
valve group was 0.64 (95% CI 0.29-1.41, p-value = 0.27).
Conclusion : Using a non-return catheter valve might not prevent CAUTI among critically ill patients.
Keywords : Non-return catheter valve, Catheter-associated urinary tract infection, Critically ill patients
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