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Background: Catheter-associated urinary tract infections (CAUTI) have been shown to increase hospital length of stay, healthcare costs, morbidity, and mortality. Studies that evaluate the role of urinary catheter design in preventing CAUTI are lacking. One such design is the double-balloon (DB) urinary catheter that has a second distal balloon; this design is aimed at reducing mucosal injury and inhibiting coiling of the in situ catheter. We carried out a comparative study to (a) determine whether CAUTI rates differ for different types of urinary catheters, and (b) identify risk factors associated with the acquisition of CAUTI in patients with DB vs. non-double-balloon (NDB) urinary catheters.

Methods: We conducted a retrospective cohort study of all patients who acquired CAUTI from January 2017 through December 2018. We collected age, sex, body mass index, medical history including benign prostatic hypertrophy, urinary tract infection (UTI), prostate cancer, stroke, surgery within the last 30 days including the type of surgery, indication for indwelling urinary catheter, location of catheter insertion, duration of catheterization, presence of pyuria, and type of catheter used. Statistical analyses were carried out using IBM SPSS software. Test statistics included independent sample t-test. CAUTI rates were expressed per 1000 catheter-days.

Results: Sixty-seven patients acquired CAUTI during the study period. NDB catheters included the following types: Foley, temperature sensing catheters, and coude catheters. Patients with DB and NDB catheters were similar in age, gender, diabetes, history of stroke, history of recent surgery, or history of UTI. CAUTI rates among patients with the DB catheters was 28 events per 29,018 catheter-days vs. 39 events per 33,579 catheter days for NDB type (P = NS). On stratification, CAUTI rates for foley, temperature sensing catheters, and coude catheters were 1.12, 1.27 and 2.70, respectively (P = NS).

Conclusion: There were no statistically significant differences in CAUTI rates at our facility among patients with DB vs. NDB urinary catheters. The decision on the choice of the catheter for use in our facility will likely depend on the comparative costs of the respective catheters.

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Open Forum Infectious Diseases, v. 6, issue Supplement_2, p. S534