Highlights
- •Evidence regarding effectiveness of meatal cleaning is inconclusive.
- •Antiseptic meatal cleaning may be an effective strategy to reduce or prevent CAUTI.
- •Effectiveness of meatal cleaning should be tested using a well-designed RCT.
- •Cost effectiveness of any potential antiseptic intervention should be considered.
Abstract
Urinary tract infections related to indwelling urinary catheters, known as catheter-associated
urinary tract infections (CAUTI), are largely preventable healthcare-associated infections
(HAI). Healthcare-associated infections including CAUTI are associated with prolonged
hospital stay, increased resistance of microorganisms to antimicrobials, increased
morbidity and mortality as well as additional financial burden on health care systems,
patients and their families. While the optimal aim for patients and the health care
system is to prevent CAUTI using measures such as reducing unnecessary placement and
early removal of urinary catheters, there is evidence that cleaning of the meatal
or peri-urethral area with antiseptic prior to catheter insertion and care of this
area while the catheter is insitu has the potential to reduce CAUTI. Evidence suggests
that meatal cleaning with antiseptics while the catheter is insitu is non-beneficial
in reducing CAUTI but current international and Australian guidelines for infection
control professionals identifies that the benefit of antiseptic solution versus non-antiseptic
solution for meatal or peri-urethral cleaning before urinary catheter insertion remains
unresolved. This discussion paper therefore focuses primarily on antiseptic meatal
cleaning prior to urinary catheter insertion in preventing CAUTI. Using evidence from
a recently published systematic review and meta-analysis of the literature, this paper
discusses the scope of the problem and limitations in the evidence regarding the effectiveness
of antiseptics for preventing CAUTI and finally, proposes a way forward through the
undertaking of a rigorously conducted randomised controlled trial aimed at evaluating
the effectiveness and cost-effectiveness of antiseptic meatal cleaning for prevention
of CAUTI.
Keywords
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Article info
Publication history
Published online: July 04, 2017
Accepted:
June 21,
2017
Received in revised form:
June 21,
2017
Received:
March 24,
2017
Identification
Copyright
© 2017 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.
