Rates of bacteriuria in laboring women with epidural analgesia: continuous vs intermittent bladder catheterization

• Published in: American journal of obstetrics and gynecology 2012-04, Vol.206 (4), p.316.e1-316.e7
• Main Authors: Millet, Lauren, MD, Shaha, Steve, PhD, DBA, Bartholomew, Marguerite Lisa, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analgesia, Epidural - adverse effects; Analgesia, Epidural - statistics & numerical data; Bacteremia - diagnosis; Bacteremia - epidemiology; Bacteremia - etiology; Bacterial diseases; Bacterial diseases of the urinary system; bacteriuria; Biological and medical sciences; Delivery. Postpartum. Lactation; epidural analgesia; Female; Foley catheter; Gynecology. Andrology. Obstetrics; Human bacterial diseases; Humans; Infectious diseases; intermittent catheterization; Labor, Obstetric; Medical sciences; Obstetrics and Gynecology; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - etiology; Pregnancy Complications, Infectious - microbiology; Urinary Catheterization - adverse effects; Urinary Catheterization - methods; Urinary Catheterization - statistics & numerical data; Young Adult
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2012.02.018

Objective The purpose of this study was to compare the rates of bacteriuria in laboring women with epidural analgesia with the use of intermittent bladder catheterization (IC) vs continuous indwelling Foley catheterization (CIF). Study Design We conducted a randomized, nonblinded trial in which 160 laboring women received IC or CIF. An initial catheterized urine culture was taken at the time of epidural placement. A second catheterized or voided culture was taken at discharge. Results were analyzed to compare bacteriuria rates between CIF and IC with the use of the Center for Disease Control (CDC) and Infectious Disease Society of America (IDSA) definitions. Results Samples from 146 women were analyzed. Randomization, demographics, and labor characteristics were not significantly different between groups; 5.48% of the samples met CDC criteria for bacteriuria, and 17.8% of the samples met IDSA criteria. In the IC group, 7 samples (8.9%) met CDC criteria for bacteriuria, and 18 samples (22.8%) met IDSA criteria for bacteriuria. In the CIF group, 1 sample (1.5%) met CDC criteria, and 8 samples (12.1%) met IDSA criteria. There was a significantly higher rate of bacteriuria by both criteria in the IC group among all deliveries, all vaginal deliveries, and spontaneous vaginal deliveries ( P < .05). Conclusion Compared with CIF, IC was associated with significantly higher rates of bacteriuria.