Preventive Effects of Urethral Orifice Cleaning versus Disinfection for Catheter Associated Urinary Tract Infections in China:A Meta-analysis

Abstract：Objective To systematically review the preventive efficacy of urethral orifice cleaning versus disinfection for urethral catheter associated urinary tract infections(CA-UTI)in China.Methods PubMed,Embase,The Cochrane Library(Issue 9),CBM,CNKI,VIP and WanFang Data were searched from their establishment to Sep.2016 to collect relevant randomized controlled trials(RCTs)comparing urethral orifice cleaning and disinfection for preventing CA-UTI in China.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.The meta-analysis was performed using RevMan5.3 software.Results A total of 25 RCTs involving 2780 patients were included.The results of meta-analysis showed as follows.①There was no significant difference on asymptomatic bacteriuria rate between urethral orifice cleaning group and disinfection group at the third day(RR=1.00,95％ CI 0.69～1.43,P=0.89)and the seventh to tenth day(RR=0.95,95％ CI 0.71～1.27,P=0.72).Asymptomatic bacteriuria rate was lower in urethral orifice cleaning group than that in disinfection group at the fourteenth day;②There was no significant difference on urinary tract infection rate between urethral orifice cleaning group and disinfection group at the third day(RR=1.14,95％ CI 0.76～1.71,P=0.53),the seventh to tenth day(RR=1.04,95％ CI 0.77～1.40,P=0.80)and the fourteenth day(RR=1.02,95％ CI 0.73～1.45,P=0.89);③Rates of adverse effects including skin allergy and inflamed hot pain were significantly lower in urethral orifice cleaning group than those in disinfection group(RR=0.23,95％ CI 0.09～0.61,P=0.003).Conclusion Current evidence demonstrates that urethral orifice cleaning is comparable to disinfection for preventing CA-UTI in China.In addition,urethral orifice cleaning has lower rate of asymptomatic bacteriuria and less adverse effect than disinfection.