Hospital-Onset Infections: A Patient Safety Issue

Letters5 August 2003Hospital-Onset Infections: A Patient Safety IssueJames R. Johnson, MDJames R. Johnson, MDMinneapolis Veterans Affairs Medical Center and University of Minnesota; St. Paul, MN 55417 (Johnson)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-3-200308050-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Gerberding's comments regarding the possible utility of antimicrobial urinary catheters in preventing nosocomial gram-negative urosepsis are incomplete and possibly misleading (1). First, only four of the eight studies in the cited meta-analysis of silver catheters addressed the currently marketed silver alloy catheter, and these were from the same investigators at a single institution in Sweden and reported unusually high infection rates among controls (2). Second, although two recent studies were cited as confirming the conclusions of the meta-analysis, only one eliminated biased assessment of outcomes by random allocation of catheters by patient and systematic collection of ...References1. Gerberding JL. Hospital-onset infections: a patient safety issue. Ann Intern Med. 2002;137:665-70. [PMID: 12379067] LinkGoogle Scholar2. Saint S, Elmore JG, Sullivan SD, Emerson SS, Koepsell TD. The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis. Am J Med. 1998;105:236-41. [PMID: 9753027] CrossrefMedlineGoogle Scholar3. Maki DG, Knasinski V, Halvorson KT, Tambyah PA. A novel silver-hydrogel urinary catheter reduces catheter-associated urinary tract infections. A prospective, randomized, double-blind trial [Abstract]. Infect Control Hosp Epidemiol. 1998; 19(Suppl N):682. Abstract no. 10. Google Scholar4. Darouiche RO, Smith JA, Hanna H, Dhabuwala CB, Steiner MS, Babaian RJ, . Efficacy of antimicrobial-impregnated bladder catheters in reducing catheter-associated bacteriuria: a prospective, randomized, multicenter clinical trial. Urology. 1999;54:976-81. [PMID: 10604693] CrossrefMedlineGoogle Scholar5. Maki DG, Knasinski V, Tambyah PA. A prospective investigator-blinded trial of a novel nitrofurazone-impregnated urinary catheter [Abstract]. Infect Control Hosp Epidemiol. 1997; 18(Suppl):P50. Abstract no. M49. Google Scholar Author, Article, and Disclosure InformationAuthors: James R. Johnson, MDAffiliations: Minneapolis Veterans Affairs Medical Center and University of Minnesota; St. Paul, MN 55417 (Johnson)Note: Dr. Johnson has received grant support from Bayer, Merck, Wyeth-Ayerst, and Ortho-McNeil and has served as a consultant for and received grant support from Rochester Medical Group, the manufacturer of the nitrofurazone catheter. 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