Skip to main content
Log in

Catheter-associated infections in urology: Possible use of silver-impregnated catheters and the erlanger silver catheter

  • Published:
Infection Aims and scope Submit manuscript

Summary

Indwelling urinary catheters play a very important part in urology. However, their use is accompanied by a considerable increase in the risk of nosocomial urinary tract infections. The pathophysiological cause is ascribed to pathogens that adhere to the catheter surface, proliferate and produce a biofilm. In addition to aseptic techniques, modification of the catheter material to confer antimicrobial activity plays an essential part in the prevention of catheter-related urinary tract infections. The antimicrobial efficacy of silver against gram-positive and gram-negative bacteria is well known and amply shownin vitro. The efficacy of silver-impregnated catheters is critically dependent on both the chemical structure of the incorporated silver and the way the silver has been combined with the basic catheter material. Hence, clinical studies on silver-modified catheters have so far given inconsistent results. The new technology of the Erlanger silver catheter offers the opportunity of an effective reduction in catheter-related infections.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Nosokomiale Infektionen in Deutschland—Erfassung und Prävalenz (NIDEP-Studie): Band 56, Schriftenreihe des Bundesministeriums für Gesundheit. Nomos Verlagsgesellschaft, Baden-Baden 1995.

    Google Scholar 

  2. Garibaldi, R. A.: Hospital acquired urinary tract infections. In:Wenzel, R. (eds.): Trevention and control of nosocomial infections. Williams & Wilkins, Baltimore 1997, pp. 600–615.

    Google Scholar 

  3. Tambyah, P. A.: SHEA Conference 1997, abstr. M48.

  4. Stamm, W. E.: Catheter-associated urinary tract infections: epidemiology, pathogenicity, and prevention. Am. J. Med. 91 (1991) 865–871.

    Google Scholar 

  5. Reid, G., Mei, H. C., Busscher, H. J.: Microbial biofilms and urinary tract infections. In:Brumfitt, W. Hamilton-Miller, J. M., Bailey, R. R. (eds.): Urinary tract infections. Campman & Hall Medical, 1998, pp. 111–116.

  6. Naber, K. G.: Rationale Diagnostik und Therapie von Harnwegs-infektionen. Urologe B 37 (1997) 328–334.

    Article  Google Scholar 

  7. Edin-Liljegren, A., Grenabo, L., Hedelin, H., Pettersson, S., Wang, Y. H.: Long-term studies of urease induced crystallisation in human urine. J. Urol. 152 (1994) 208–212.

    PubMed  CAS  Google Scholar 

  8. NNIS-Report. Am. J. Infect. Control 25 (1997) 477–487.

  9. Centers for Disease Control: Guidelines for prevention of catheterassociated urinary tract infections 1998.

  10. Stark, R. P., Maki, D.: Bacteriuria in the catheterized patient. What quantitative level of bacteriuria is relevant? N. Engl. J. Med. 311 (1984) 560–564.

    Article  PubMed  CAS  Google Scholar 

  11. Definitionen nosokomialer Infektionen (CDC-Definitionen): Robert-Koch-Institut, Berlin 1998.

  12. Warren, J. W., Tenney, J. H., Hoopes, J. M., Muncie, H. L., Anthony, W. C.: A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J. Infect. Dis. 146 (1982) 719–723.

    PubMed  CAS  Google Scholar 

  13. Butler, H. K., Kranin, C.M.: Evaluation of polymyxin catheter lubricant and impregnated catheters. J. Urol. 100 (1968) 560–566.

    PubMed  CAS  Google Scholar 

  14. Desautels, R. E., Walter, C. W., Graves, R. C., Harrison, J. H.: Technical advances in the prevention of urinary tract infection. J. Urol. 87 (1962) 487.

    PubMed  CAS  Google Scholar 

  15. Guggenbichler, J.-P., Böswald, M., Lugauer, S., Krall, T.: A new technology of microdispersed silver in polyurethane induces antimicrobial activity in central venous catheters. Infection 27 (Suppl. 1) (1999) S 16–23.

    Google Scholar 

  16. Zhao, G., Stevens, S. E.: Multiple parameters for the comprehensive evaluation of the susceptibility ofEscherichia coli to the silver ion. Biometals 11 (1998) 27–32.

    Article  PubMed  CAS  Google Scholar 

  17. Gabriel, M. M., Sawant, A. D., Simmons, R. B., Ahearn, D. G.: Effects of silver on adherence of bacteria to urinary catheters:in vitro studies. Curr. Microbiol. 30 (1995) 17–22.

    Article  PubMed  CAS  Google Scholar 

  18. Gabriel, M. M., Mayo, M. S., May, L. L., Simmson, R. B., Ahearn, D. G.:In vitro evaluation of the efficacy of a silver-coated catheter. Curr. Microbiol. 33 (1996) 1–5.

    Article  PubMed  CAS  Google Scholar 

  19. Wuhrmann, K., Zobrist, F.: Untersuchungen über die bakterizide Wirkung von Silber in Wasser. Schweiz. Z. Hydrol. 20 (1958) 218–254.

    Article  CAS  Google Scholar 

  20. Li, X. Z., Nikaido, H., Williams, K. E.: Silver-resistant mutants ofEscherichia coli display active efflux of the Ag+ and are deficient in porins. J. Bacteriol. 179 (1997) 6127–6132.

    PubMed  CAS  Google Scholar 

  21. Deshpande, L. M., Chopade, B. A.: Plasmid mediated silver resistance inAcinetobacter baumannii. Biometals 7 (1994) 49–56.

    Article  PubMed  CAS  Google Scholar 

  22. Starodub, M. E., Trevors, J. T.: Silver accumulation and resistance inEscherichia coli. R1. J. Inorg. Biochem. 39 (1994) 317–325.

    Article  Google Scholar 

  23. Stickler, D. J., Morris, N. S., Williams, T. J.: An assessment of the ability of a silver-releasing device to prevent bacterial contamination of urethral catheter drainage systems. Br. J. Urol. 78 (1996) 579–588.

    PubMed  CAS  Google Scholar 

  24. Lundeberg, T.: Prevention of catheter associated urinary infections by use of silver-impregnated catheters. Lancet ii (1986) 1031.

    Article  Google Scholar 

  25. Liedberg, H., Lundeberg, T.: Silver alloy coated catheters reduce catheter-associated bacteriuria. Br. J. Urol. 65 (1990) 379–381.

    Article  PubMed  CAS  Google Scholar 

  26. Liedberg, H., Lundeberg, T., Ekman, P.: Refinements in the coating of urethral catheters reduce the incidence of catheter-associated bacteriuria. An experimental and clinical study. Eur. Urol. 17 (1990) 379–381.

    Google Scholar 

  27. Liedberg, H., Lundeberg, T.: Prospective study of incidence of urinary tract infections in patients catheterized with bard hydrogel and silver-coated catheters or bard hydrogel-coated catheters. J. Urol. 149 (1992) 405A (abstr.).

    Google Scholar 

  28. Riley, D. K., Classen, D. C., Stevens, L. E., Burke, J. P.: A large randomized clinical trial of a silver impregnated urinary catheter: lack of efficacy and staphylococcal superinfection. Am. J. Med. 98 (1995) 349–356.

    Article  PubMed  CAS  Google Scholar 

  29. Johnson, J. R., Roberts, P. L., Olsen, R. J., Moyer, K. A., Stamm, W. E.: Prevention of catheter-associated urinary tract infection with a silver oxide-coated urinary catheter: clinical and microbiologic correlates. J. Infect. Dis. 162 (1990) 1145–1150.

    PubMed  CAS  Google Scholar 

  30. Saint, S., Elmore, J. G., Sullivan, S. D., Emmerson, S. S., Koepsell, T. D.: The efficacy of silver alloy coated urinary catheters in preventing urinary tract infection: a meta analysis. Am. J. Med. 105 (1998) 236–241.

    Article  PubMed  CAS  Google Scholar 

  31. Takeuchi, H., Hida, S., Yoshida, O., Ueda, T.: Clinical study on efficacy of a foley catheter coated with silver-protein in prevention of urinary tract infections. Hinyokika Kiyo 39 (1993) 293–298.

    PubMed  CAS  Google Scholar 

  32. Nakada, J., Kawahara, M., Onodera, S., Oishi, Y.: Clinical study of silver lubricant foley catheter. Hinyokika Kiyo 42 (1996) 433–438.

    PubMed  CAS  Google Scholar 

  33. Konishi, T., Tomoyoshi, T., Johnin, K.: Electron microscopic study on the surface of long-term indwelling silver-protein-coated urethral catheters. Hinyokika Kiyo 43 (1997) 19–23.

    PubMed  CAS  Google Scholar 

  34. Morris, N. S., Stickler, D. J., Winters, C.: Which indwelling urethral catheters resist encrustation byProteus mirabilis biofilms? Br. J. Urol. 80 (1997) 58–63.

    PubMed  CAS  Google Scholar 

  35. Haacke, C., Schierholz, J., Timpe, K.: Neue Materialien zur Harnleiterschienung—Mythen und Fakten. Urologe B 37 (1997) 243–246.

    Article  Google Scholar 

  36. Böswald, M., Lugauer, S., Regenfus, A., Braun, G. G., Martus, P., Geis, C., Scharf, J., Bechert, T., Greil, J., Guggenbichler, J.-P.: Reduced rates of catheter-associated infections by use of a new silver-impregnated central venous catheter. Infection 27 (Suppl. 1) (1999) S 56–59.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rösch, W., Lugauer, S. Catheter-associated infections in urology: Possible use of silver-impregnated catheters and the erlanger silver catheter. Infection 27 (Suppl 1), S74–S77 (1999). https://doi.org/10.1007/BF02561624

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02561624

Keywords

Navigation