Does periurethral cleaning with water prior to indwelling urinary catheterization increase the risk of urinary tract infections? A systematic review and meta-analysis.

To determine whether periurethral cleaning with water before indwelling urinary catheterization increases the risk of urinary tract infections (UTIs) compared with studies using anti-infective agents.

A literature search via MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials through October 2017 and a manual search of references for additional relevant studies. Trials studying clean intermittent catheterization were excluded. Data were extracted independently by 2 reviewers. Disagreements were resolved through discussion. Results of randomized controlled trials were pooled using random effects models. Both individual and pooled risk estimates were reported using risk ratios (RRs) and 95% confidence intervals (CIs).

From 121 identified articles, 5 studies involving 824 patients were included in the review (822 patients included in meta-analysis). No statistical significance in the incidence of UTIs existed between the water group and antiseptics group (RR, 1.07; 95% CI, 0.77-1.49; P = .89; I2 = 0%). Available data comparing water with povidone-iodine or chlorhexidine gluconate demonstrated no significant difference between the incidence of UTIs (RR, 1.10; 95% CI, 0.66-1.83; P = .79; I2 = 0%; and RR, 1.05; 95% CI, 0.68-1.62; P = .72; I2 = 0%; respectively).

Based on current data, water is as safe as other topical antiseptics for periurethral cleansing before indwelling urinary catheter insertion.

American journal of infection control. 2018 May 31 [Epub]

Kun Huang, Jihong Liang, Ting Mo, Yanli Zhou, Yanping Ying

Department of Andrology and Sex Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China., Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. Electronic address: .

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