Article

OBJECTIVE: To explore whether bladder irrigation with chlorhexidine: (i) can
reduce bacteriuria, and (ii) is a practically feasible option in subjects with
spinal cord injury practicing intermittent self-catheterization. DESIGN: A prospective, non-controlled, open, multi-centre study. METHODS: Fifty patients
with spinal cord injury, practicing intermittent self-catheterization, with a
history of recurrent urinary tract infections were screened for bacteriuria at
follow-up visits to 4 spinal cord injury centres in Sweden.
Twenty-three patients
had a positive urine culture (> 105 CFU/ml of > 1 bacterial species), of which 19
completed the study. Subjects proceeded with bladder irrigation, using 120 ml of
0.2% chlorhexidine solution twice daily for up to 7 days. Urine samples were
taken twice daily. Response to treatment was defined as reduction in bacterial
counts to < 103 CFU/ml. RESULTS: Fourteen of 19 subjects reduced their bacterial
counts to or below the set limit. Subsequent return of above-endpoint bacteriuria
was seen in most of the subjects. However, there were significantly fewer
subjects with bacteriuria after treatment (p <0.005). CONCLUSION: Bladder
irrigation with chlorhexidine, using intermittent self-catheterization, reduced
bacteriuria in the majority of subjects with spinal cord injury and bacteriuria.
The addition of bladder irrigation was practically feasible in the short
time-frame of this study.

Langue : ANGLAIS