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Chlorhexidine for meatal cleaning before catheterization prevents ASB, UTIs
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Using chlorhexidine solution for meatal cleaning before urinary catheterization significantly decreases the incidence of catheter-associated asymptomatic bacteriuria and UTIs, according to findings from a randomized controlled trial.
“UTIs are a common health care-associated infection and a large proportion of these are associated with the high usage of indwelling urinary catheters,” Oyebola Fasugba, PhD, a researcher at Australian Catholic University and St Vincent's Health Australia, and colleagues wrote. “Bacteriuria due to urinary catheterization can represent colonization (catheter-associated asymptomatic bacteriuria) or symptomatic infection (catheter-associated UTI).”
According to the study, the proportion of hospitalized patients who receive a urinary catheter is 18% in the United Kingdom, 24% in the United States and 26% in Australia, and evidence for the benefits of antiseptic meatal cleaning prior to catheterization to reduce UTIs is inconclusive.
Fasugba and colleagues performed a cross-sectional, stepped-wedge, open-label, randomized controlled trial in Australian hospitals to assess the efficacy a 0.1% chlorhexidine solution for meatal cleaning to reduce catheter-associated asymptomatic bacteriuria and UTIs compared with normal saline.
According to the study, three hospitals accounting for 1,642 participants were selected and randomly assigned to one of three intervention crossover dates between Aug. 1, 2017, and March 12, 2018. Fasugba and colleagues enrolled 697 participants in the control phase and 945 in the intervention period.
According to the results, there were 13 catheter-associated UTIs and 29 catheter-associated asymptomatic bacteriuria events recorded in 2,889 catheter-days in the control period compared with four catheter-associated UTIs and 16 catheter-associated asymptomatic bacteriuria events in 2,338 catheter-days during the intervention period. Overall, the researchers found that the intervention was associated with a 74% reduction in the incidence of catheter-associated asymptomatic bacteriuria (incidence rate ratio [IRR] = 0.26; 95% CI, 0.08–0.86), and a 94% decrease in the incidence of catheter-associated UTI (IRR = 0.06; 95% CI, 0.01–0.32), with no reported adverse events.
“Catheter-associated UTI has substantial health and economic implications for patients and the health care system; hence, strategies to reduce this infection are warranted,” Fasugba and colleagues concluded. “Our study suggests that 0.1% chlorhexidine solution might be an effective antiseptic meatal-cleaning product before urinary catheterization in preventing catheter-associated asymptomatic bacteriuria and UTI, with the potential to improve safety for hospitalized patients.” – by Caitlyn Stulpin
Disclosures: The authors report no relevant financial disclosures.
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