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
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/15/4463 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Vineet Gauhar |
| collection | DOAJ |
| description | 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 <i>p</i>-values. Significance was set at <i>p</i> < 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, <i>p</i> = 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, <i>p</i> = 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. |
| first_indexed | 2024-03-09T05:18:09Z |
| format | Article |
| id | doaj.art-74d837f1220c490489ae9106fec6472d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T05:18:09Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-74d837f1220c490489ae9106fec6472d2023-12-03T12:43:21ZengMDPI AGJournal of Clinical Medicine2077-03832022-07-011115446310.3390/jcm11154463Catheter-Associated Urinary Infections and Consequences of Using Coated versus Non-Coated Urethral Catheters—Outcomes of a Systematic Review and Meta-Analysis of Randomized TrialsVineet Gauhar0Daniele Castellani1Jeremy Yuen-Chun Teoh2Carlotta Nedbal3Giuseppe Chiacchio4Andrew T. Gabrielson5Flavio Lobo Heldwein6Marcelo Langer Wroclawski7Jean de la Rosette8Rodrigo Donalisio da Silva9Andrea Benedetto Galosi10Bhaskar Kumar Somani11Department of Urology, Ng Teng Fong General Hospital (NUHS), Singapore 609606, SingaporeUrology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, ItalyS.H.Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, ChinaUrology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, ItalyUrology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, ItalyBrady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USADepartment of Urology, Universidade Federal de Santa Catarina, Florianópolis 88040-900, BrazilHospital Israelita Albert Einstein, São Paulo 05652-900, BrazilDepartment of Urology, Medipol Mega University Hospital, Istanbul Medipol University, 34214 Istanbul, TurkeyDivision of Urology, Denver Health Medical Center, University of Colorado, Denver, CO 80204, USAUrology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, ItalyDepartment of Urology, University Hospitals Southampton, NHS Trust, Southampton SO16 6YD, UKCoated 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 <i>p</i>-values. Significance was set at <i>p</i> < 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, <i>p</i> = 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, <i>p</i> = 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.https://www.mdpi.com/2077-0383/11/15/4463urinary catheterscathetersindwellingcatheter-related infections |
| spellingShingle | 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 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 Journal of Clinical Medicine urinary catheters catheters indwelling catheter-related infections |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | urinary catheters catheters indwelling catheter-related infections |
| url | https://www.mdpi.com/2077-0383/11/15/4463 |
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