Title

Meatal Cleaning with Antiseptics for the Prevention of Catheter-Associated Urinary Tract Infections: A Discussion Paper

Author Faculty (Discipline)

Nursing

Document Type

Article

Publication Date

9-2017

Early Online Version

7-4-2017

JOURNAL

Infection Disease and Health

VOLUME NUMBER

22

ISSUE NUMBER

3

PAGE NUMBERS

136-143

ISSN

2468-0451

Embargo Period

7-20-2018

ANZSRC / FoR Code

111002 Clinical Nursing: Primary (Preventative)| 111716 Preventive Medicine

Avondale Research Centre

Lifestyle Research Centre

Reportable Items (HERDC/ERA)

C1

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.

Link to publisher version (DOI)

https://doi.org/10.1016/j.idh.2017.06.004

Peer Review

Before publication

Comments

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© 2017 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.

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