Effect of disinfection of urethral orifice before catheterization on the prevention of catheter-associated urinary tract infection: A Meta-analysis

Abstract:

Objective To explore the effect of disinfection of urethral orifice with antiseptic agent before catheteri-zation on the prevention of catheter-associated urinary tract infection (CAUTI) by Meta-analysis, provide reference for domestic clinical work and the formulation of CAUTI prevention strategy. Methods WanFang data, China national knowledge infrastructure(CNKI), China Biology Medicine disc (CBM), PubMed, The Cochrane library, Web of Science databases and EMbase were electronically retrieved to collect randomized controlled trials (RCTs) about the effect of urethral orifice disinfection before catheterization on the prevention of CAUTI, the retrieval time was from database establishment to August 2021. Two researchers independently screened the literatures, extracted data, evaluated the bias risk of the included literatures, Stata 12.0 software was adopted to conduct Meta-analysis, sensitivity analysis and publication bias analysis, GPower 3.1 software was used for efficacy analysis. Results A total of 7 RCTs were included, including 3 030 patients with urinary catheterization. Meta-analysis showed that there was no significant difference in the incidence of CAUTI between disinfection and cleaning of urethral orifice before catheterization (OR=0.78, 95%CI: 0.57-1.08, P=0.380), whether the countries were with extremely high human development index (OR=0.75, 95%CI: 0.46-1.22, P=0.243) or high human development index (OR=0.91, 95%CI: 0.56-1.47, P=0.839), whether the positive criterion of urine culture was colony number >10⁵ CFU/mL (OR=0.71, 95%CI: 0.47-1.08, P=0.316) or >10³ CFU/mL (OR=1.06, 95%CI: 0.58-1.91, P= 0.642), difference in the incidence of CAUTI between disinfection and cleaning of the urethral orifice before catheterization was not statistically significant. Conclusion Systematic evaluation and Meta-analysis results show that there is no difference in the efficacy of preventing CAUTI between disinfection and cleaning of urethral orifice before catheterization, which is inconsistent with the requirements of relevant guidelines for CAUTI prevention in China, however, more high-quality studied in medical environment of China are still need to be conducted to formulate CAUTI prevention standards in line with national conditions of China.