An effective evidence-based cleaning method for the safe reuse of intermittent urinary catheters: In vitro testing
An effective evidence-based cleaning method for the safe reuse of intermittent urinary catheters: In vitro testing
AIMS: To determine a safe bactericidal cleaning method that does not damage urethral catheters used for intermittent catheterization. In some countries, single-use catheters are the norm; in others, the reuse of catheters is common depending on health insurance, personal preference, or individual concerns about the environment. However, no recent study of cleaning methods has been published to provide evidence for the safe reuse of catheters.
METHODS: Using advanced microbiological methods, a laboratory study of eight cleaning methods was conducted. Sections of uncoated polyvinylchloride (PVC) catheters were exposed to bacterial uropathogens in physiologically correct artificial urine media then tested with a range of heat, chemical, and mechanical cleaning methods. Analysis of culturable and viable but nonculturable (VBNC) bacteria was done and direct microscopy was used. Descriptive statistics were used to compare values.
RESULTS: Heat treatments, although effective, resulted in catheter surface breakdown and damage. Ultrasonic cleaning and vinegar showed evidence of VBNC populations indicating the methods were bacteriostatic. Detergent and water wash followed by immersion in a commercially available 0.6% sodium hypochlorite solution and 16.5% sodium chloride (diluted Milton) gave consistent bactericidal results and no visible catheter damage.
CONCLUSIONS: Combined mechanical and chemical treatment of a detergent and water wash followed by immersion in diluted Milton (the "Milton Method") provided consistent and effective cleaning of uncoated PVC catheters, showing bactericidal action for all uropathogens tested after repeated exposure. If found safe in clinical testing, this method could increase the reuse of catheters, reduce plastic waste in the environment, reduce cost, and increase patient choice.
cleaning, decontamination, intermittent catheterization, patient choice, reuse, sodium hypochlorite, uropathogens, viable but nonculturable (VBNC)
907-915
Wilks, Sandra A.
86c1f41a-12b3-451c-9245-b1a21775e993
Morris, Nicola S.
3fa10eae-2f64-4af3-a27c-37bd74843590
Thompson, Richard
f439ea56-b6dd-48cf-8adb-d9c2ecc6e24d
Prieto, Jacqui A.
47dd42cd-35d5-4ece-8fc6-fdb8fe1f01cc
Macaulay, Margaret
505970d3-1e67-4c1f-8291-3a950d336c6b
Moore, Katherine N.
a579bf99-6450-4185-98fa-bf15c8478eef
Keevil, C. William
cb7de0a7-ce33-4cfa-af52-07f99e5650eb
Fader, Mandy
c318f942-2ddb-462a-9183-8b678faf7277
31 March 2020
Wilks, Sandra A.
86c1f41a-12b3-451c-9245-b1a21775e993
Morris, Nicola S.
3fa10eae-2f64-4af3-a27c-37bd74843590
Thompson, Richard
f439ea56-b6dd-48cf-8adb-d9c2ecc6e24d
Prieto, Jacqui A.
47dd42cd-35d5-4ece-8fc6-fdb8fe1f01cc
Macaulay, Margaret
505970d3-1e67-4c1f-8291-3a950d336c6b
Moore, Katherine N.
a579bf99-6450-4185-98fa-bf15c8478eef
Keevil, C. William
cb7de0a7-ce33-4cfa-af52-07f99e5650eb
Fader, Mandy
c318f942-2ddb-462a-9183-8b678faf7277
Wilks, Sandra A., Morris, Nicola S., Thompson, Richard, Prieto, Jacqui A., Macaulay, Margaret, Moore, Katherine N., Keevil, C. William and Fader, Mandy
(2020)
An effective evidence-based cleaning method for the safe reuse of intermittent urinary catheters: In vitro testing.
Neurourology and Urodynamics, 39 (3), .
(doi:10.1002/nau.24296).
Abstract
AIMS: To determine a safe bactericidal cleaning method that does not damage urethral catheters used for intermittent catheterization. In some countries, single-use catheters are the norm; in others, the reuse of catheters is common depending on health insurance, personal preference, or individual concerns about the environment. However, no recent study of cleaning methods has been published to provide evidence for the safe reuse of catheters.
METHODS: Using advanced microbiological methods, a laboratory study of eight cleaning methods was conducted. Sections of uncoated polyvinylchloride (PVC) catheters were exposed to bacterial uropathogens in physiologically correct artificial urine media then tested with a range of heat, chemical, and mechanical cleaning methods. Analysis of culturable and viable but nonculturable (VBNC) bacteria was done and direct microscopy was used. Descriptive statistics were used to compare values.
RESULTS: Heat treatments, although effective, resulted in catheter surface breakdown and damage. Ultrasonic cleaning and vinegar showed evidence of VBNC populations indicating the methods were bacteriostatic. Detergent and water wash followed by immersion in a commercially available 0.6% sodium hypochlorite solution and 16.5% sodium chloride (diluted Milton) gave consistent bactericidal results and no visible catheter damage.
CONCLUSIONS: Combined mechanical and chemical treatment of a detergent and water wash followed by immersion in diluted Milton (the "Milton Method") provided consistent and effective cleaning of uncoated PVC catheters, showing bactericidal action for all uropathogens tested after repeated exposure. If found safe in clinical testing, this method could increase the reuse of catheters, reduce plastic waste in the environment, reduce cost, and increase patient choice.
Text
nau.24296
- Version of Record
More information
Accepted/In Press date: 24 December 2019
e-pub ahead of print date: 24 March 2020
Published date: 31 March 2020
Keywords:
cleaning, decontamination, intermittent catheterization, patient choice, reuse, sodium hypochlorite, uropathogens, viable but nonculturable (VBNC)
Identifiers
Local EPrints ID: 439158
URI: http://eprints.soton.ac.uk/id/eprint/439158
ISSN: 0733-2467
PURE UUID: e4421bc1-866b-4000-b017-08f5554bccbf
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Date deposited: 06 Apr 2020 16:30
Last modified: 10 Jan 2022 03:12
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Contributors
Author:
Nicola S. Morris
Author:
Richard Thompson
Author:
Katherine N. Moore
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