Catheter associated urinary tract infection (CAUTI) is the most common healthcare associated infection. A significant knowledge gap exists regarding the necessity of catheter replacement as part of CAUTI treatment.
Current guidelines recommend replacement for faster recovery and to prevent recurrences, but adherence is low. In this systematic review, we aimed to assess the available evidence regarding catheter replacement for CAUTI.
Eligible studies investigated the effect of catheter replacement in CAUTI on clinical outcomes and/or recurrence rates, irrespective of catheter type or setting. We searched electronic literature databases from inception to October 15th, 2023. Information was extracted regarding setting, eligibility criteria, definition of CAUTI, timing of replacement, and outcomes.
Of the 257 identified studies, four were considered relevant and included. Two were randomized controlled trials (RCT) and two were observational studies. One RCT showed higher rates of clinical recovery and lower recurrence rates in the replacement group, while results of the other RCT favoured retainment, with a lower recurrence rate in the retainment group, although longer antimicrobial treatment in this group. Two observational studies were inconclusive.
Current guidelines rely heavily on recommendations from a single study, emphasizing the need for further research. The burden of catheter replacement, including patient discomfort and resource impact, warrants careful consideration. A randomized trial is essential to provide more evidence on the effect of catheter replacement on clinical outcomes including CAUTI recurrence.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 2024 Jun 25 [Epub ahead of print]
Annette C Westgeest, Janneke I M van Uhm, Laura Pattacini, Wouter Rozemeijer, Barbara M A Schout, Rolf H H Groenwold, Suzanne E Geerlings, Merel M C Lambregts
Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, Netherlands., Department of Urology, Leiden University Medical Center, Leiden, Netherlands., Department of Medical Microbiology, Northwest Clinics, Alkmaar, Netherlands., Department of Urology, Alrijne Ziekenhuis, Leiderdorp, Netherlands., Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands., Department of Internal Medicine, Division Infectious Diseases, Amsterdam Institute Infection and Immunity, Amsterdam, Netherlands., Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, Netherlands. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38916643