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Revista de la Facultad de Medicina

Print version ISSN 0120-0011

Abstract

SAENZ-MONTOYA, Ximena; GRILLO-ARDILA, Carlos Fernando; AMAYA-GUIO, Jairo  and  MUNOZ-VESGA, Jessica. Use of non-pharmacological interventions during urinary catheter insertion for reducing urinary tract infections in non-immunocompromised adults. A systematic review. rev.fac.med. [online]. 2020, vol.68, n.1, pp.24-33. ISSN 0120-0011.  https://doi.org/10.15446/revfacmed.v68n1.74383.

Introduction:

Catheter-associated urinary tract infections (CAUTI) account for up to 30% of hospital -acquired infections. In this regard, several studies have reported the use of non-pharmacological interventions during urinary catheter insertion aimed at reducing the occurrence rate of CAUTI.

Objective:

To assess the safety and effectiveness of non-pharmacological interventions during urinary catheter insertion aimed at reducing the risk of contracting infections in non-immunocompromised adults.

Materials and methods:

A literature review was conducted in the MEDLINE, Embase, and LILACS databases. Only randomized clinical trials comparing the use of non-pharmacological interventions to placebos, pharmacological interventions, or no intervention during catheter insertion were included.

Results:

Eight studies were retrieved (8 718 participants). Based on the evidence found in the review (low-quality and very low-quality evidence according to the GRADE system), using non-pharmacological interventions reduces the frequency of asymptomatic bacteriuria episodes (RR 0.67, 95%CI 0.48-0.94; 7 studies) or mild adverse events (RR 0.84, 95%CI 0.74-0.96; 2 studies), but does not reduce the occurrence rate of symptomatic urinary tract infections (RR 0.90, 95%CI 0.61-1.35; 4 studies) or improves quality-of-life scores (MD -0.01 EQ-5D scale; 95%CI (-0.03)-(0.01), 1 study).

Conclusion:

The use of non-pharmacological interventions during urinary catheter insertion does not pose any risk at all. Instead, it could help reduce the occurrence rate of infections associated with this procedure, such as asymptomatic bacteriuria and mild adverse events. However, there is very little evidence (in fact, low and very low-quality evidence) to make conclusions on the effectiveness of these interventions.

Keywords : Early Medical Intervention; Urinary Catheterization; Urinary Tract Infections; Cross Infection (MeSH).

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