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

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.