Breaking News
October 22, 2018 - The International Society of Refractive Surgery honors Vivior Chairman with Casebeer Award
October 22, 2018 - Multi-strain probiotic helps reduce chemotherapy-induced diarrhea in cancer patients
October 22, 2018 - Study shows potential of avelumab plus axitinib as new treatment option for patients with advanced RCC
October 22, 2018 - Vertex gets European CHMP positive opinion for KALYDECO to treat patients with cystic fibrosis
October 22, 2018 - Phase III trial reports positive results with HDAC inhibitor in advanced breast cancer patients
October 22, 2018 - Prostate radiotherapy improves survival in men with low burden of metastatic disease
October 22, 2018 - Free phone app helps low-income obese patients to lose weight
October 22, 2018 - Compression Collar May Protect Brain of Female Soccer Players
October 22, 2018 - Technique visualizes neuron communication
October 22, 2018 - Advancement in medical imaging methods for health care
October 22, 2018 - Takeda presents vedolizumab phase 3 VISIBLE 1 trial results for treatment of moderately to severely active ulcerative colitis
October 22, 2018 - Immunotherapy increases survival in some patients with metastatic triple negative breast cancer
October 22, 2018 - Exelixis presents CABOSUN and METEOR trial results in patients with advanced renal cell carcinoma
October 22, 2018 - LYNPARZA Phase III SOLO-1 results show improved outcome for patients with advanced BRCA-mutated ovarian cancer
October 22, 2018 - Brainlab unveils ExacTrac Dynamic at ASTRO meeting in San Antonio, Texas
October 22, 2018 - Not exercising is worse than smoking, diabetes or heart disease finds study
October 22, 2018 - Shorter course of trastuzumab could be an option for women with HER2+ early breast cancer
October 22, 2018 - Map of Mouse Hippocampus Could Be Weapon Against Alzheimer’s
October 22, 2018 - Psychotropic polypharmacy is common in Alzheimer’s disease
October 22, 2018 - Texas A&M and UTA establish Texas Genomics Core Alliance
October 22, 2018 - Analyzing mouse’s potential as animal model of decision-making
October 22, 2018 - Radiotherapy can prolong survival in prostate cancer
October 22, 2018 - A genetic mutation involved in relapse
October 21, 2018 - Report reveals growing impact of cannabis on young people
October 21, 2018 - NSF awards $5 million grant to help scientists magnify societal impact of research
October 21, 2018 - Fertility Rates Down for Each Urbanization Level 2007 to 2017
October 21, 2018 - Genetically engineered 3-D human muscle transplant in a murine model
October 21, 2018 - Moms’ tight work schedules may affect their children’s sleep
October 21, 2018 - AHA: No Direct Link Between Preeclampsia and Cognitive Impairment, Study Finds
October 21, 2018 - Weight loss success linked with active self-control regions of the brain
October 21, 2018 - Scripps researchers successfully test potential new smoking-cessation treatment in rodents
October 21, 2018 - More accurate and less stressful way to measure a baby’s heartbeat
October 21, 2018 - Researchers show better cardiorespiratory fitness leads to longer life
October 21, 2018 - Healthy candies for diabetic patients
October 21, 2018 - Environment impact of microplastics remains unclear
October 21, 2018 - Antibiotics for appendicitis? Surgery often not needed
October 21, 2018 - AHA and AMA recognize more than 800 medical practices, health systems for blood pressure control
October 21, 2018 - Scientists obtain clearest ever image of Ebola virus protein
October 21, 2018 - Study reveals connection between two proteins known to be hyperactive in cancer
October 21, 2018 - Gabapentin Beats Pregabalin for Chronic Sciatica
October 21, 2018 - Cosmetic surgeons offering incomplete information for breast augmentation customers
October 21, 2018 - Chronic sleep disruption in early adult life accelerates AD-related tau pathology
October 21, 2018 - Take 10 for Mindfulness – Drugs.com MedNews
October 21, 2018 - Length of breathing disruption in OSA may be better predictor of mortality risk
October 21, 2018 - ApoE4 gene linked with chronic inflammation increases risk for Alzheimer’s disease
October 21, 2018 - Mother-daughter conflict associated with suicide risk in abused adolescent girls
October 21, 2018 - Scientists molding bacteria into unnatural shapes
October 21, 2018 - High diet quality associated with lower risk of death in colorectal cancer patients
October 21, 2018 - Discharged mental health patients ‘at greater risk of dying’
October 21, 2018 - Research provides insight into neurobiology of aggression and bullying
October 21, 2018 - As billions in tax dollars flow to private Medicaid plans, Who’s minding the store?
October 21, 2018 - Neuroscientists identify brain region that appears to be related to food preference decisions
October 21, 2018 - Deaths related to air pollution in the U.S. decreased by 47% between 1990 and 2010
October 21, 2018 - Study shows correlation between spatial memory and the sense of smell
October 21, 2018 - Increased cardiorespiratory fitness associated with reduced long-term mortality
October 21, 2018 - IU researchers receive $1.55 million from NIH to improve chronic-disease management
October 21, 2018 - Income and wealth affect the mental health of Australians, study shows
October 21, 2018 - Patients with hypertension and psoriasis more often require cardiovascular interventions
October 20, 2018 - Leading hip-hop videos depict use of tobacco and marijuana products, study finds
October 20, 2018 - Dose Range of IV Ketamine for Adjunct Tx of Depression Tested
October 20, 2018 - Infants can distinguish between leaders and bullies, study finds
October 20, 2018 - Mad Cow disease found on Aberdeenshire farm
October 20, 2018 - Study identifies factors associated with prescription opioid misuse among students
October 20, 2018 - Scientists uncover key regulator of mTORC1 in cancer growth
October 20, 2018 - Pounds Regained After Weight-Loss Op Can Tell Your Doc a Lot
October 20, 2018 - Sending parents letters to fight childhood obesity doesn’t work
October 20, 2018 - Supervised aerobic exercise can support major depression treatment
October 20, 2018 - Mindfulness-based program effective for reducing stress in infertile women
October 20, 2018 - Molecule capable of halting and reverting neurodegeneration caused by Parkinson’s disease identified
October 20, 2018 - Midazolam-mediated alterations of PER2 expression may have functional consequences during myocardial ischemia
October 20, 2018 - Sweat bees are ideal for studying the genes underlying social behavior
October 20, 2018 - Weight loss success associated with brain areas involved in self-control
October 20, 2018 - KHN’s ‘What the Health?’ Republicans’ preexisting political problem
October 20, 2018 - Research provides a more complete picture of suffering caused by terrorist attacks
October 20, 2018 - Eradicating Helicobacter pylori infections may be a key treatment for Parkinson’s disease
October 20, 2018 - Breast Cancer as a Dynamic Disease
October 20, 2018 - University of Pittsburgh wins NSF grant for big data research to prevent complications from anesthesia
October 20, 2018 - Skin-to-skin contact may promote attachment between parents and preterm infants
October 20, 2018 - Recommendations Developed to Verify NGT Placement in Children
October 20, 2018 - Weight loss can be boosted fivefold thanks to novel mental imagery technique
Clinician re-examines evidence on re-use of catheters and UTIs in people with spinal cord injuries

Clinician re-examines evidence on re-use of catheters and UTIs in people with spinal cord injuries

image_pdfDownload PDFimage_print

People with spinal cord injuries rely on catheters to empty their bladder. When a well-respected publication concluded that catheters could be reused without an increased risk of infection, it didn’t sit right with a Vancouver clinician and researcher. He had spoken to wheelchair athletes about this very issue while working at the Summer Paralympics in London.

“Wheelchair athletes from wealthier countries would only use each catheter once while athletes from developing countries would clean and reuse their catheters again and again,” said Dr. Andrei Krassioukov, a professor of medicine at UBC and chair in rehabilitation research with ICORD. “The athletes who used catheters only once experienced three-to-four times fewer urinary tract infections than athletes who reused catheters.”

Urinary tract infections can be disruptive to people’s daily lives, resulting in time off work or from other activities. Antibiotics are prescribed to treat urinary tract infections. People with spinal cord injury are at higher risk for urinary tract infection.

The issue of whether people can reuse catheters or if they should be single-use has long been debated in the medical community. A catheter costs anywhere from $5 to $30 and people with spinal cord injuries use a new catheter every time they need to empty their bladder.

Around the world, and even within Canada, there are large differences in the coverage of costs for catheters. In some countries, like France, it is illegal to reuse catheters. In other places, countries cannot afford to cover the costs of single-use catheters.

Cochrane is a well-established organization that collects data from many studies and provides evidence for best practices in medicine. In 2014, Cochrane reviewed evidence from 31 clinical trials to compare single vs. multiple-use catheters and urinary tract infections. The review found that there was no convincing evidence that the incidence of infection was affected by catheterization.

From his clinical experience and his study conducted at the Paralympics, Krassioukov had a “gut feeling” that the results were wrong. He assembled a team of experts from around the world to re-examine the evidence. They found a number of errors and wrote to Cochrane’s acting editor-in-chief to alert him. An updated analysis by Cochrane, published in 2017, has since been withdrawn.

The team also systematically reviewed all 31 trials included in the 2014 Cochrane review and performed a meta-analysis of the data. They published their own findings last month in the Journal of Neurotrauma, indicating that the studies tend to favour single-use catheters.

“Until evidence can confidently demonstrate that multiple use is as safe as single use, health-care providers should advocate for single-use of catheters since catheter cleaning is a major issue,” said Krassioukov. “This will affect the direction on how we manage patients.”

While several groups have tried to develop catheters and sterilization techniques so that catheters can be reused safely, they have yet to be successful. When catheters are reused, bacteria are introduced that can cause infection in the urinary tract.

Co-authors of this study include Kathleen Christison, a UBC medical student who conducted this research as part of her program, Matthias Walter, a postdoctoral fellow at ICORD, Vanessa Noonan and Nader Fallah from the Rick Hansen Institute, and international collaborators Jean-Jacque Wyndaele, Dr. Michael Kennelly and Dr. Thomas Kessler.

Additional quotes:

Márcio Averbeck, head of neuro-urology at Moinhos de Vento Hospital in Brazil:

Most of my peers in Brazil do give a lot of value to the Cochrane reviews. The medical community truly appreciated the critical appraisal of the Cochrane review regarding re-use of catheters and urinary tract infections. It will impact our clinical practice in Brazil.

Ari Seirlis, chief executive officer of QuadPara Association of South Africa:

For many years, I was using a catheter for months at a time, washing the catheter between uses, and reusing it until it got replaced. This came with numerous bladder infections. Since using single-use catheters, I have not had a bladder infection in the last three years at least.

Source:

‘Gut feeling’ spurs doctor to re-examine evidence on urinary tract infections in patients with spinal cord injury

Tagged with:

About author

Related Articles