A systematic review and meta-analysis of the effectiveness of antiseptics for meatal cleaning in the prevention of catheter associated urinary tract infections
Fasugba, O., Koerner, J., Mitchell, B. G. and Gardner, A.. (2017) A systematic review and meta-analysis of the effectiveness of antiseptics for meatal cleaning in the prevention of catheter associated urinary tract infections. Journal of Hospital Infection. 95(3), pp. 233-242. https://doi.org/10.1016/j.jhin.2016.10.025
|Authors||Fasugba, O., Koerner, J., Mitchell, B. G. and Gardner, A.|
Background: Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections. Antiseptic cleaning of the meatal area before and during catheter use may reduce the risk of CAUTIs.
Aim: To undertake a systematic review of the literature and meta-analysis of studies investigating the effectiveness of antiseptic cleaning before urinary catheter insertion and during catheter use for prevention of CAUTIs.
Methods: Electronic databases were searched to identify randomized controlled trials. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and compared across intervention and control groups using DerSimonian–Laird random-effects model. Subgroup analyses were performed. Heterogeneity was estimated using the I2 statistic.
Findings: In total, 2665 potential papers were identified; of these, 14 studies were eligible for inclusion. There was no difference in the incidence of CAUTIs when comparing antiseptic and non-antiseptic agents (pooled OR 0.90, 95% CI 0.73–1.10; P=0.31), or when comparing different agents: povidone-iodine vs routine care; povidone-iodine vs soap and water; chlorhexidine vs water; povidone-iodine vs saline; povidone-iodine vs water; and green soap and water vs routine care (P > 0.05 for all). Comparison of an antibacterial agent with routine care indicated near significance (P=0.06). There was no evidence of heterogeneity (I2=0%; P > 0.05). Subgroup analyses showed no difference in the incidence of CAUTIs in terms of country, setting, risk of bias, sex and frequency of administration.
Conclusions: There were no differences in CAUTI rates, although methodological issues hamper generalizability of this finding. Antibacterial agents may prove to be significant in a well-conducted study. The present results provide good evidence to inform infection control guidelines in catheter management.
|Keywords||antiseptic; meatal cleaning; urinary catheter; urinary tract infection; systematic review; meta-analysis|
|Journal||Journal of Hospital Infection|
|Journal citation||95 (3), pp. 233-242|
|Publisher||Elsevier - WB Saunders|
|Digital Object Identifier (DOI)||https://doi.org/10.1016/j.jhin.2016.10.025|
|Open access||Published as green open access|
|Research or scholarly||Research|
|Research Group||School of Nursing, Midwifery and Paramedicine|
|Author's accepted manuscript|
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