The University of Southampton
University of Southampton Institutional Repository

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
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)
0733-2467
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
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), 907-915. (doi:10.1002/nau.24296).

Record type: Article

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
Available under License Creative Commons Attribution.
Download (1MB)

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
ORCID for Sandra A. Wilks: ORCID iD orcid.org/0000-0002-4134-9415
ORCID for Jacqui A. Prieto: ORCID iD orcid.org/0000-0002-5524-6775
ORCID for Margaret Macaulay: ORCID iD orcid.org/0000-0003-1737-4589
ORCID for C. William Keevil: ORCID iD orcid.org/0000-0003-1917-7706

Catalogue record

Date deposited: 06 Apr 2020 16:30
Last modified: 18 Feb 2021 17:33

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×