Nosocomial catheter-associated bacteriuria: a clinical trial comparing two closed urinary drainage systems

We compared the time of onset and incidence of nosocomial bacteriuria between two different closed urinary drainage systems: a simple closed drainage system containing an antireflux valve ('Urias A-4') and a complex closed drainage system ('Curity Infection Control System') incorporating: (1) a preconnected, coated catheter, (2) a tamper discouraging seal at the catheter-drainage tubing junction, (3) a drip chamber, (4) an antireflux valve, (5) a hydrophobic drainage bag vent and (6) a povidone-iodine releasing cartridge in line with the outlet tube of the urine collection bag. 181 non-bacteriuric patients, requiring catheter drainage for more than 48 h, were assigned by chance to either of the two systems. Bacteriological monitoring of bladder urines of the enrolled patients was performed every 24 h by establishing viable counts and identification of all microorganisms. No differences in the onset and incidence of nosocomial bacteriuria between the two urine drainage system groups were noted. We conclude that additional complex features aimed at preventing intraluminal spread of bacteria did not reduce the risk of urinary tract infection, compared to a simple closed urinary drainage system.