The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterisation: A systematic review

Abstract

OBJECTIVE: This systematic review had two aims. First to identify the incidence of urinary tract infection (UTI) and bacteriuria in people undertaking intermittent catheterisation (IC), second to determine the effectiveness of antiseptic cleaning of the meatal area prior to IC in reducing the incidence of UTI and bacteriuria. DESIGN: A systematic review was conducted. METHODS: Medline and the Cumulative Index to Nursing and Allied Health Literature electronic databases were systematically searched between 1st January 1990 and 31(st) January 2020, to identify studies that reported either the incidence of UTI or bacteriuria or the impact of using antiseptics for meatal cleaning prior to IC on incidence of these same outcomes. RESULTS: Twenty-five articles were identified for the first aim, two articles for the second. The proportion of participants experiencing ≥1 UTIs per year ranged from 15.4% to 86.6%. Synthesis of these studies suggest a combined incidence of 44.2% [95%CI 40.2-48.5%] of participants having ≥1 UTIs per year. One of the two studies exploring the benefit of antiseptics in reducing UTI suggest some potential benefit of using chlorhexidine in reducing UTIs. Both studies have significant limitations, making interpretation difficult. CONCLUSION: A large proportion of people undertaking IC in the community have UTIs each year. Evidence on the role of antiseptics in the prevention of UTI for people who undertake IC remains unclear.