PDF(Pubmed)
Abstract：
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
目的：导管相关性尿路感染（CAUTI）是最常见的医疗保健相关感染。关于导管置换作为CAUTI治疗的一部分的必要性存在显著的知识差距。当前指南建议更换以加快恢复速度并防止复发，但坚持率很低。在这次系统审查中，我们的目的是评估有关CAUTI导管置换的现有证据.
方法：符合条件的研究调查了导管置换对CAUTI临床结局和/或复发率的影响，无论导管类型或设置。我们搜索了从成立到10月15日的电子文献数据库，2023年。提取了有关设置的信息，资格标准，CAUTI的定义，更换的时间,和结果。
结果：在257项确定的研究中，四个被认为是相关的，包括在内。两项为随机对照试验（RCT），两项为观察性研究。一项RCT显示置换组的临床恢复率较高，复发率较低，虽然其他RCT的结果有利于保留，保留组的复发率较低，虽然该组的抗菌治疗时间较长。两项观察性研究尚无定论。
结论：目前的指南在很大程度上依赖于一项研究的建议，强调需要进一步研究。更换导管的负担，包括患者不适和资源影响，值得仔细考虑。一项随机试验对于提供更多关于导管置换对包括CAUTI复发在内的临床结果的影响的证据至关重要。
方法：符合条件的研究调查了导管置换对CAUTI临床结局和/或复发率的影响，无论导管类型或设置。我们搜索了从成立到10月15日的电子文献数据库，2023年。提取了有关设置的信息，资格标准，CAUTI的定义，更换的时间,和结果。
结果：在257项确定的研究中，四个被认为是相关的，包括在内。两项为随机对照试验（RCT），两项为观察性研究。一项RCT显示置换组的临床恢复率较高，复发率较低，虽然其他RCT的结果有利于保留，保留组的复发率较低，虽然该组的抗菌治疗时间较长。两项观察性研究尚无定论。
结论：目前的指南在很大程度上依赖于一项研究的建议，强调需要进一步研究。更换导管的负担，包括患者不适和资源影响，值得仔细考虑。一项随机试验对于提供更多关于导管置换对包括CAUTI复发在内的临床结果的影响的证据至关重要。
