Blaaskatheterisatie Module 2 Evidence-tabel

Evidence table for systematic review of RCTs and observational studies (intervention studies)

Study reference

Study characteristics

Patient characteristics

Intervention (I)

Comparison / control (C)

Follow-up

Outcome measures and effect size

Comments

Mitchell, 2021

[individual study characteristics deduced from Mitchell, 2021

 

SR and meta-analysis of [RCTs / cohort / case-control studies]

Literature search up to Feb 2020

A: Duffy, 1995

B: Carapeti, 1996

C: Fasugba, 2019

D: King, 1992

E: Nasiriani, 2009

F: Webster, 2001

Study design:

A: RCT

B: RCT

C: RCT

D: RCT

E: RCT

F: RCT

Setting and Country:

A: male veterans in long-term care, USA

B: General surgery patients, UK

C: Medical and surgical patients, ICU, Australia

D: Spinal cord injury rehabilitation inpatients, USA

E: Female gynaecological surgery patients, Iran

F: Pregnant obstetrics patients, Australia

Source of funding and conflicts of interest:

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors

First author reports personal fees and grants outside the submitted work.

Inclusion criteria SR: RCTs and quasi-experimental studies evaluating the use of antiseptic, antibacterial or non-medicated agents for cleaning the meatal, periurethral or perineal areas before indwelling catheter insertion or intermittent catheterisation

Exclusion criteria SR: not published in English language, focused solely on children (≤18 years), included patients with pre-existing UTIs, or were published in grey literature

6 studies included (1 for comparison A, 5 for comparison B)

Important patient characteristics at baseline:

N, mean age (I) / N, mean age (C)

A: 42, 72.6/38, 70.9

B: 74, 67.5 / 82, 65.3

C: 945, NR / 697, NR

D: 23, 32.8 / 23, 27.9

E: 30, NR / 30, NR

F: 217, NR / 219, NR

Sex:

NR

Groups comparable at baseline?

No indications for incomparable groups

Describe intervention:

A: sterile technique for insertion of the catheter

B: 0.3% CHG

C: 0.1% CHG solution

D: Povidoneiodine solution

E: Povidoneiodine solution

F: 0.1% CHG solution

 

Describe control:

A: clean technique for insertion of the catheter

B: Tap water

C: 0.9% saline

D: Castile soap wipe

E: Tap water

F: Tap water

 

End-point of follow-up:

NR

For how many participants were no complete outcome data available?

NR

 

1.catheter-associated urinary tract infections

Comparison A clean vs sterile

21/38 patients (55%) in the ‘clean’ group developed a urinary tract infection compared to 26/42 patients (62%) in the ‘sterile’ group. The risk ratio was 0.89 (95% CI:0.62 - 1.29).

Comparison B cleaning of the genitals

C: Thirteen patients (13/697) in the saline group developed a urinary tract infection compared to four (4/945) in the chlorhexidine group. The risk ratio was 4.41 (CI 1.44, 13.46).

  1. Bacteriuria

Comparison A clean vs sterile

Not reported

Comparison B cleaning of the genitals

B: OR 0.85 [0.30 – 2.40]

C: OR 0.40 [0.21 – 0.74]

D: OR 0.69 [0.21 – 2.28]

E: OR 0.80 [0.22 – 2.97]

F: OR 1.13 [0.58 – 2.21]