Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 9386

AbstractMaterial and MethodsResultsDiscussionConclusionKey MessageReferences
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
Knowledge is treasure of a wise man. The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help ones reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journalsNo manuscriptsNo authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2008 | Month : August | Volume : 2 | Issue : 4 | Page : 991 - 996

Comparison Of Povodine-Iodine Versus Savlon For Pre-Catheterization Cleansing And The Association Of Bacteriuria With Its Antibiotic Susceptibility In Catheterised Patients Of The Surgical Ward

SHOBHA K.L, RAMACHANDRA L, RAO S.P.

Department of Microbiology Melaka Manipal Medical College Manipal 576104

Correspondence Address :
Dr Shobha K.L Professor Department of Microbiology
Melaka Manipal Medical College
Manipal 576104 E.Mail: shobhamicro@yahoo.com

Abstract

Background:Urinary tract infection is one of the most common nosocomial infections, and urinary catheterization is the most frequent predisposing factor. Nosocomial infections associated with urinary catheters may increase the mortality rate upto three times. These infections also pose a considerable financial burden. Different methods for urinary tract infection prophylaxis have been proposed for patients who undergo continuous catheterization. This study compared the disinfection of the genital area with Povodine –Iodine or Savlon (Chlorhexidine and Cetrimide) before inserting the Foley’s catheter with respect to the quantitative results of the urine culture and sensitivity to commonly used antibiotics.
Methods:Hundred inpatients who underwent clean continuous catheterization with the Foley’s catheter post operatively in the surgical ward, were divided into groups ‘A’ and ‘B’.Group ‘A’ and group ‘B’ consisted of 50 patients each. Group ‘A’ patients were directed to use povodine –iodine as a disinfectant for pre-catheterization cleansing, and group ‘B’ was directed to use savlon. The control group included 50 post operative patients, those who were not on urinary catheters. The urine sample was collected shortly after the catheter was inserted, and the samples with no growth on the culture plate were only included in the study. Patients with a previous history of urinary tract infection or with growth on the culture plates collected from urine immediately after catheterization, and patients with congenital urinary tract anomaly, were excluded from the study. Catheter samples were collected using a sterile needle and syringe. Urine samples collected on the third and fifth day of catheterization were processed and considered to be culture positives if the count was >10(4) organisms per milliliter of urine. Midstream urine samples were collected from the postoperative patients without urinary catheters. Organisms were identified by conventional biochemical methods, and susceptibility to antimicrobial agents was tested by the Kirby-Bauer standardized disc-diffusion technique.
Results: 14% patients in group A and 16% in group B developed bacteriuria and candiduria by the end of the 5th day of catheterization. Females had higher rate of bacteriuria than males, following three days and five days of catheterization in both the groups (Group A female: male bacteriuria ratio on third day was 2(8%):1(4%) and on fifth day 4(16%): 3(12%).Group B female:male bacteriuria ratio on third day and fifth day were 2(7.62%):1(4.16%) and 5(19.23%:3(6.25%). None from group A and one from group B presented with symptoms. .Klebsiella species was the commonest organism isolated, followed by candida species and E.coli. Our study showed no significant difference between disinfecting with Povodine –Iodine or Savlon in the pre-catheterization cleansing procedure and the occurrence of bacteriuria..Microorganisms were sensitive to cephalosporins and amikacin, and were resistant to commonly used antibiotics like Trimethoprim-sulfamethoxazole, ampicillin and gentamicin. None of the controls had any bacteriuria.
Interpretation: Performing catheterization by a proper aseptic procedure using available disinfectants should be thought as a preventive measure, and use of appropriate antimicrobial drug therapy with developing drug resistance should also be considered during treatment.

Keywords

Bacteriuria, urinary catheters, surgical ward

Introduction
Urinary tract infection (UTI) is one of the most common nosocomial infections(1)(2), and urinary catheterization is the most frequent predisposing factor(3) in eighty percent(1) of patients. In another study, all of the nosocomial urinary tract infections were associated with the (Foley’s) catheter. There is also a strong prevalence of UTI in catheterized females(5).In spite of a change from open to closed drainage systems, more than 30% of catheterized patients develop UTI[(2),(3),(4),(5),(6) but many remain asymptomatic(7). Nosocomial infections associated with urinary catheter may increase the mortality rate upto three times(7). These infections also pose a considerable financial burden(8).In the current study, comparison of Povodine-Iodine versus Savlon for pre-catheterization cleansing and the association of bacteriuria with duration of catherization were analysed . Causative organisms and their antibiograms for catheter associated bacteriuria in a surgical ward at Kasturba Medical College Hospital, Manipal, were studied.

Material and Methods

Hundred inpatients in the age group of 19 years to 60 years, admitted to the surgical ward at Kasturba Medical College hospital, Manipal, were included in the study. A prospective study was conducted in the period from November 2005 to July 2006. The study group was divided into group ‘A’ and ‘B’. Consent was taken from the patients before the procedure, and the patients were divided into two groups. The first male patient was included in group ‘A’ and the second male patient was included in group ‘B’. Similarly, the first female patient was included in Group ‘A’ and the second female patient was included in Group ‘B’. No other criteria was considered in the division of groups. Our study did not include any blinding methods .Exclusion criteria in our study included patients with a history of urinary tract abnormalities, and patients with a history of previous urinary tract infection and the first urine sample collected immediately after catheterization showing significant bacteriuria. Group ‘A’ consisted of 50 patients with 25 females and 25 males, and group ‘B’ consisted of 50 patients with 24 females and 26 males. 50 patients with 25 females and 25 males in the age group of 18 to 60 years who underwent surgery, but were not on urinary catheters postoperatively, were the controls. Group ‘A’ Patients were directed to use Povodine –Iodine IP5% W/V ( Available iodine 0.5% W/V) (Wockhardt limited ,Aurangabad , India), and group ‘B’ was directed to use Savlon 1% ( Chlorhexidine IP 0.75% and cetrimide IP 0.15%, Isopropile alcohol IP 0.04% , purified water QS ) (Kasturba medical college pharmacy,Manipal,India) for pre-catheterization cleansing. Male patients were injected 2ml of 2% lidocaine jelly into the urethral meatus before inserting the Foley’s catheter, and for female patients, the Foley’s catheter was lubricated with lidocaine jelly before inserting the catheter. Urine cultures and urine analysis were carried out immediately after catheterization on the third day and fifth day of insertion of the catheter, with a total of 3 samples from each patient. Catheter samples were collected by using a sterile needle and syringe, and the urine was processed and considered culture positive if the count was >10(4) organisms per milliliter of urine .Urine samples were refrigerated immediately after collection, and were kept for no longer than an hour before being plated with a calibrated loop onto blood agar, CLED medium and MacConkey’s agar. The plates were incubated at 370 C aerobically, and were read after 24 hours of incubation. The presence or absence of bacteria or fungus, the number of colonies, and the isolated types were identified according to the conventional biochemical methods described by Weaver and colleagues(9). Susceptibility to antimicrobial agents were tested by the Kirby-Bauer standardized disc–diffusion technique(10) . Mueller-Hinton agar (Hi-Media,Mumbai ,India) was used for the inoculation of readymade antibiotic discs(Span Diagnostics,Surat,India) .The density of the organisms was adjusted to approximately 10(8) colony –forming units by comparing its turbidity with that of 0.5 Mc Farland opacity standard. Control strain E.coli ATTC 25922 was used in the antibiotic discs quality control. Zones of complete growth inhibition around each of the discs were carefully measured. The interpretation of zone size into susceptible or resistant was based on the Kirby- Bauer interpretation chart. The inclusion criteria were that patients with their urine samples collected and inoculated into culture plates shortly after the catheter insertion, and those showing no growth on the culture plates, were only included in the study. Patients with a previous history of urinary tract infection, those with growth on the culture plates after they were inoculated with urine collected immediately after catheterization, and patients with a history of urinary tract abnormality, were excluded from the study.

Results

A prospective study of hundred inpatients divided into groups ‘A’ and ‘B’, with 50 patients in each group, were included. Females had higher rate of bacteriuria than males, following three days and five days of catheterization in both the groups. None from group A and one from group B presented with symptoms. Females had higher rate of bacteriuria than males following three days and five days of catheterization in both the groups. (Table/Fig 1) The most common organism isolated was Klebsiella species in both males and females, followed by Candida species , E.coli and other organisms ( 3 strains, each organism had only one strain each and it was grouped as others) (Pseudomonas species 1, Citrobacter species 1, Coagulase negative staphylococcus species 1 strain).[Table/Fig1] .

Mid stream urine collected from the control group, when processed, did not grow any organisms on the culture plates. Organisms isolated were sensitive to cefotaxime and amikacin.Most of the strains were resistant to ampicillin,and Trimethoprim-sulfamethoxazole (Table/Fig 2)

Discussion

Our finding showed that 14% of patients in group A using povodine –iodine, and 16% in group B using Savlon as disinfectant for pre-catheterization cleansing, developed bacteriuria . The number of cases of bacteriuria increased with the longer duration of catheterization. This study was in concordance with the study conducted by Kunin CM and Stamn WE et al(11)(12) The study conducted by Stamm WE et al , Coropeti EA et al , Shoefr AJ et al and Hilton P et al, showed that more than 30% of patients developed catheter associated bacteriuria(2),(3),(4),(5),(6). A study conducted by Garibaldi et al showed that risk of bacteriuria increased by 5% for each additional day the catheter is in situ(11) . Our study showed an overall 15% bacteriuria which was in concordance with the study conducted by Raz R et al (12) , who had 12.3% patients having bacteriuria in the surgical ward .There was correlation between duration of catheterization and occurrence of bacteriuria (P<0.05)
14% patients in group A and 16% in group B had developed bacteriuria and candiduria by the end of the 5th day. None from group A and one from group B presented with symptoms. Platt R et al(7) and Paul A et al(13) in their study, found that more than 90% of the infected patients were asymptomatic. Our study also had the same findings .Out of 15 patients with bacteriuria, only one presented with symptoms. Group A on the third day, had 2 females and one male with bacteriuria, and on the fifth day, 4 females and 3 males presented with bacteriuria (Female: Male bacteriuria , 4:3). Group B on the third day had 2 females and 1 male with bacteriuria, and on the 5th day, 5 females and 3 males presented with bacteriuria ( Female:Male bacteriuria ,5:3). Females were more prone to develop bacteriuria than males.This study was in concordance with the study conducted by Hussain et al (14)and Jespen OB et al(5). Klebsiella species was the commonest organism isolated, followed by candida species and E.coli. Our study showed no significant difference between disinfecting with Povodine –Iodine or Savlon in pre-catheterization cleansing in preventing bacteriuria, probably because the number of cases of bacteriuria were very few . Microorganisms were sensitive to cephalosporins and amikacin, and resistant to commonly used antibiotics like Trimethoprim-sulfamethoxazole (TMP/SMX), ampicillin and gentamicin.

Conclusion

The results of this study showed no significant difference between the two disinfectants when compared, Povodine –Iodine or Savlon in pre-catheterization cleansing and the prevention of bacteriuria. Performing catheterization with proper aseptic procedure, using available disinfectants, should be thought as the preventive measure, and use of appropriate antimicrobial drug therapy with developing drug resistance should also be considered during treatment

Key Message

1. Povodine –Iodine or Savlon in pre-catheterization cleansing and the prevention of bacteriuria.
2. Females had higher rate of bacteriuria than males
3. Klebsiella species was the commonest organism isolated from both groups
4. Microorganisms were sensitive to cephalosporins and amikacin.

References

1.
Warren JW, Nosocomial urinary tract infections in , Mondell Douglas,Bennett eds. Principles and practice of infectious diseases, 3rd edition USA:Churchill Livingstone:1990
2.
Stamm WE: Guidelines for prevention of catheter associated urinary tract infections. Annals Intern Med 1975:82:386-90
3.
Coropeti EA,Andrews SM,Bentley PG. Randomised study of sterile versus nonsterile urethral catheterization :Ann .R.Coll.Surg.Engl:1996:78:59-60
4.
Shoefr AJ, Chmiel J: Urethral meatal colonization in the pathogenesis of catheter associated bacteriuria:J.Urol:1983:130:1096-99
5.
Jespen OB,Loreen SO,Donker J.:UTI and bacteremia in hospitalized medical patients,a European multicenter prevalence survey on nosocomial infection:J .Hosp.Infect.1982:3(3):241-52
6.
Hilton P:Bladder drainage ,a survey of practices among gynaecologists in the British isles:BR.J.Obstet.Gynaecol:1988:95:1178-89
7.
Platt R, Polk BF,Murdock B,Ronser B:Mortality associated with nosocomial UTI infection :N.Engl.J.Med.:1982:307:637-42
8.
Givens CD,Wenzel RP:Catheter associated UTI in surgical patients :a controlled study on the excess morbidity and costs:J.Urol.1986:124:646-48
9.
Weaver R.E, Tatum H.W., Hollis D.C. The identification of unusual pathogenic gram-negative bacteria.Preliminary revision of Kings chart. Center for Disease Control,Atlanta,Ga. 1972.
10.
Bauer AW,Kirby WMM,Sherris JC,Turck M:Antibiotic susceptibility testing by a standardized single disk method:Am.J.Clin.Pathol.1966:45:493-96
11.
Garibaldi RA,Burk JP,Dickman ML and Smith CB : Factors predisposing to bacteriuria during indwelling urethral catherization : New England Journal of Medicine 1974:291:213-19
12.
Raz r ,Chazan B,Krasnianski S ,Teitler N : Risk factors for catheter associated UTI ;Abstr Inter sci conf Antimicrob Agents Chemother :2001:Dec,16-19 ;41:Abstract no L-1061
13.
Paul A,Tambyah,Dennis G,Maki M.D :Catheter-Associated Urinary tract infection Is rarely symptomatic :Arch.Intern Med:2000:160:678-68
14.
Hussain M,Oppenheim P ,O’Neill :Prospective survey of the incidence ,risk factors and outcome of hospital acquired infections in the elderly: Journal of Hospital infection:1996:32:117-26

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com