Role of noble metal-coated catheters for short-term urinary catheterization of adults: a meta-analysis

Abstract

Objective To evaluate the efficacy of noble-metal coated catheters in reducing catheter-associated urinary tract infections (CAUTI) in adult patients requiring short term catheterization. Methods An electronic literature search of PubMed, BioMed Central, Embase, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials) and Google scholar was carried out from inception to 10th October 2019. Any prospective study or randomized controlled trial (RCT) on adult patients comparing noble-metal coated urinary catheters with any standard catheter and evaluating the incidence of CAUTI or bacteriuria was included. Results A total of 13 studies were included in the systematic review. 12 were RCTs and one was a prospective cross-over trial. Catheters employed in the study group were grouped into two subgroups: Silver alloy coated or Noble metal alloy-coated (Gold, Silver, and Palladium) catheters. Bacteriuria was the most commonly studied outcome variable across trials. Metaanalysis indicated that silver alloy-coated catheters (RR 0.63, 95%CI 0.44-0.90, P = 0.01; I2 = 72%) and noble metal alloy catheters (RR 0.58, 95%CI 0.41-0.81, P = 0.001; I2 = 0%) significantly reduce the risk of bacteriuria. Subgroup analysis based on the duration of catheterization demonstrated that silver alloy catheters reduce the risk of bacteriuria with >1week of catheterization (RR 0.46, 95%CI 0.26-0.81, P = 0.007; I2 = 63%). Symptomatic CAUTI was evaluated only in four studies with variable results. The quality of the included studies was not high. Conclusions Our review indicates that bacteriuria may be reduced with the use of noble metal-coated catheters during short-term catheterization of adults, however, the quality of evidence is not

Impact of Healthcare-Associated Infections Connected to Medical Devices—An Update

“…Switching to chlorhexidine from saline has saved AUD 387,909 per 100,000 for Australian hospitals [85]. The use of silver alloy in urinary catheter coatings to reduce CAUTI is being tried, but no clear significant benefit has been observed [86,87]. The usage of fosfomycin trometamol is possible for the treatment of CAUTI patients as it possesses a low rate of bacterial resistance, and no cross-or parallel-resistance with other frequently used antibiotics has been identified [88].…”

Effectiveness of Chitosan Coating Catheter in Preventing Catheter- Associated Urinary Tract Infection (CAUTI)

“…The occurrence of CAUTI could be reduced by preventing bacterial adhesion and then biofilm formation. The use of silicon catheter and silicon coated with noble metal led to a reduction in the bacterial biofilm formation compared to other types of catheter used previously, such as latex [12][13][14]. One way to prevent bacterial adhesion is by coating the catheter's inner surfaces with antimicrobial/ antiadhesive material.…”

Association between hypoalbuminemia and mortality in patients undergoing continuous renal replacement therapy: A systematic review and meta-analysis

“…We assessed inter-study heterogeneity using the I 2 statistic. I 2 = 25–50% meant low, 50–75% meant medium, and more than 75% meant substantial heterogeneity [ 16 ]. Publication bias was assessed by funnel plot and Egger’s test [ 17 ].…”