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ELECTRONIC ARTICLE: Theresa A. Schlager, Maureen Clark, and Susan Anderson Effect of a Single-Use Sterile Catheter for Each Void on the Frequency of Bacteriuria in Children With Neurogenic Bladder on Intermittent Catheterization for Bladder Emptying Pediatrics 2001; 108: e71 [Abstract] [Full text] [PDF]

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The question is, why do this study?

Richard W CHIU   (2 October 2001)

Re: The question is, why do this study?

Amy A Egan   (22 August 2003)

Preliminary studies should not be used to change patient care policies

theresa a schlager   (2 September 2003)

The question is, why do this study? 2 October 2001
Richard W CHIU, Paediatric Nephrologist Paediatrics, Queen Mary Hospital, Hong Kong SAR, China Send letter to journal: Re: The question is, why do this study? rwchiu{at}hku.hk Richard W CHIU	Dear Dr Schlager, Having read your paper "Bacteriuria in children with neurogenic bladder treated with intermittent catheterization: Natural history" (J PEDIATR 1995;126:490-6) when it was published, I am very convinced that asymptomatic bacteriuria in patients with neuropathic bladder treated with intermittent clean catheterisation is rather benign and does not need treatment. Why do you want to do a study to reduce asymptomatic bacteriuria in this group of patients? I must acknowledge how much we were indebted to your original paper in 1995. Yours sincerely, Richard W Chiu
Re: The question is, why do this study? 22 August 2003
Amy A Egan, RN Send letter to journal: Re: Re: The question is, why do this study? kkaspurr{at}cox.net Amy A Egan	I work for a Medicaid insurance company and have been noticing excess when it comes to requesting intermittent/ straight catheters with the paraplegia population. The arguement we had is in needing a new catheter each time versus cleaning the catheters between catheterization. I believed in the home environment cleaning between use was appropriate, but received arguement from case management in that patient will have higher frequency of UTI. This article will help back up my arguement. Thank you.
Preliminary studies should not be used to change patient care policies 2 September 2003
theresa a schlager, MD Univ Virginia Send letter to journal: Re: Preliminary studies should not be used to change patient care policies tas8n{at}virginia.edu theresa a schlager	Our study examined the frequency of bacteriuria in the same patient using sterile single-use catheters for voiding versus reused clean catheters. Bacteriuria and urinary tract infection were defined. The 10 adolescents enrolled in the study had myelomeningocele, lived outside hospital and had normal upper urinary tracts. We found that use of a sterile single-use catheter for each void did not decrease the high frequency of bacteriuria. Of note, the number of urinary tract infections was too small to compare between groups. As a result, we were unable to address whether sterile single-use catheters decreased urinary tract infection in this population. A study with a larger number of patients would be required to answer this question. It is unclear whether Escherichia coli detected in the urine of patients on intermittent catheterization originates from the periurethra or from chronic colonization of the bladder mucosa. Further investigation is required to elucidate the cause of chronic bacteriuria in this population. Any policies regarding catheter use cannot be derived from this study. To do so would be unscientific and in hospitalized patients, potentially dangerous.

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