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Catheter-Associated Urinary Infections and Consequences of Using Coated versus Non-Coated Urethral Catheters—Outcomes of a Systematic Review and Meta-Analysis of Randomized Trials

Authors :
Vineet Gauhar
Daniele Castellani
Jeremy Yuen-Chun Teoh
Carlotta Nedbal
Giuseppe Chiacchio
Andrew T. Gabrielson
Flavio Lobo Heldwein
Marcelo Langer Wroclawski
Jean de la Rosette
Rodrigo Donalisio da Silva
Andrea Benedetto Galosi
Bhaskar Kumar Somani
Source :
Journal of Clinical Medicine. 11:4463
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Coated urethral catheters were introduced in clinical practice to reduce the risk of catheter-acquired urinary tract infection (CAUTI). We aimed to systematically review the incidence of CAUTI and adverse effects in randomized clinical trials of patients requiring indwelling bladder catheterization by comparing coated vs. non-coated catheters. This review was performed according to the 2020 PRISMA framework. The incidence of CAUTI and catheter-related adverse events was evaluated using the Cochran–Mantel–Haenszel method with a random-effects model and reported as the risk ratio (RR), 95% CI, and p-values. Significance was set at p < 0.05 and a 95% CI. Twelve studies including 36,783 patients were included for meta-analysis. There was no significant difference in the CAUTI rate between coated and non-coated catheters (RR 0.87 95% CI 0.75–1.00, p = 0.06). Subgroup analysis demonstrated that the risk of CAUTI was significantly lower in the coated group compared with the non-coated group among patients requiring long-term catheterization (>14 days) (RR 0.82 95% CI 0.68–0.99, p = 0.04). There was no difference between the two groups in the incidence of the need for catheter exchange or the incidence of lower urinary tract symptoms after catheter removal. The benefit of coated catheters in reducing CAUTI risk among patients requiring long-term catheterization should be balanced against the increased direct costs to health care systems when compared to non-coated catheters.

Subjects

Subjects :
General Medicine

Details

ISSN :
20770383
Volume :
11
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine
Accession number :
edsair.doi.dedup.....2e3717a646e23ab1d02958728430e8fb
Full Text :
https://doi.org/10.3390/jcm11154463