UTI Study Findings Could Help Spinal Cord Injury Patients

Acute spinal cord injury patients who are undergoing in-patient rehabilitation experience a delay in the onset and a reduction in the incidence of symptomatic urinary tract infection (UTI) when they are treated using hydrophilic-coated catheters for intermittent catheterization, as compared to an uncoated PVC catheter, according to a study published in PM&R, the journal of the American Academy of Physical Medicine and Rehabilitation.

The Miller School’s Diana D. Cardenas, M.D., M.H.A., professor and chair of the Department of Rehabilitation Medicine and chief of service at Jackson Memorial Rehabilitation Hospital, was the first author of the study of 224 participants, so far the largest randomized clinical trial investigating the effects of a hydrophilic-coated catheter with respect to the occurrence of UTI.

The University of Miami/Jackson Memorial Hospital is among 15 U.S. and Canadian spinal cord injury (SCI) centers that took part in the randomized trial in patients rehabilitating from acute spinal cord injury.

“For the patients in rehabilitation, it significantly reduced the time to their first symptomatic UTI infection, and it decreased the daily risk of developing a first infection by 33 percent,” Cardenas said about the study published in May. “The infections are preventable to some extent, but are many times unavoidable because of the loss of normal bladder function following SCI. These study results are important because they come at a time when hospitals are trying to reduce their infection rate, which is also an issue being given a lot of attention by the Centers for Medicare & Medicaid Services.”

In the prospective, parallel-group trial, participants were randomized, within 10 days of starting intermittent catheterization, to either a sterile single-use uncoated PVC catheter (Conveen), or a sterile single-use hydrophilic catheter (Speedicath). The hydrophilic catheters are coated with a compound that, when wet, becomes slick and reduces friction.

Cardenas noted that the coating compound, which allowed for the reduction in friction, resulted in patients experiencing less microscopic bleeding from intermittent catheterization. The study participants were followed, not only in rehab, but also for up to three months after discharge for a maximum combined study period of six months.

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