Department of Andrology and Sex Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
Am J Infect Control. 2018 Dec;46(12):1400-1405. doi: 10.1016/j.ajic.2018.02.031. Epub 2018 May 31.
To determine whether periurethral cleaning with water before indwelling urinary catheterization increases the risk of urinary tract infections (UTIs) compared with studies using anti-infective agents.
A literature search via MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials through October 2017 and a manual search of references for additional relevant studies. Trials studying clean intermittent catheterization were excluded. Data were extracted independently by 2 reviewers. Disagreements were resolved through discussion. Results of randomized controlled trials were pooled using random effects models. Both individual and pooled risk estimates were reported using risk ratios (RRs) and 95% confidence intervals (CIs).
From 121 identified articles, 5 studies involving 824 patients were included in the review (822 patients included in meta-analysis). No statistical significance in the incidence of UTIs existed between the water group and antiseptics group (RR, 1.07; 95% CI, 0.77-1.49; P = .89; I = 0%). Available data comparing water with povidone-iodine or chlorhexidine gluconate demonstrated no significant difference between the incidence of UTIs (RR, 1.10; 95% CI, 0.66-1.83; P = .79; I = 0%; and RR, 1.05; 95% CI, 0.68-1.62; P = .72; I = 0%; respectively).
Based on current data, water is as safe as other topical antiseptics for periurethral cleansing before indwelling urinary catheter insertion.
与使用抗感染剂的研究相比，确定留置导尿前使用水进行尿道周围清洁是否会增加尿路感染（UTI）的风险。
通过 MEDLINE、Embase 和 Cochrane 对照试验中心注册库进行文献检索，检索截至 2017 年 10 月，并对其他相关研究进行手动检索以获取额外的参考文献。排除了研究清洁间歇性导尿的试验。由 2 位审阅者独立提取数据。通过讨论解决分歧。使用随机效应模型对随机对照试验的结果进行汇总。使用风险比（RR）和 95％置信区间（CI）报告个体和汇总风险估计值。
从 121 篇确定的文章中，有 5 项研究共 824 例患者纳入综述（822 例患者纳入荟萃分析）。水组与消毒剂组之间 UTI 的发生率无统计学差异（RR，1.07；95％CI，0.77-1.49；P=0.89；I=0％）。比较水与聚维酮碘或葡萄糖酸氯己定的可用数据表明，UTI 的发生率无显著差异（RR，1.10；95％CI，0.66-1.83；P=0.79；I=0％；和 RR，1.05；95％CI，0.68-1.62；P=0.72；I=0％）。
根据现有数据，水与其他局部抗菌剂一样安全，可用于留置导尿前尿道周围清洁。
