Use of Wet Wipes for Bedridden Patients Associated with Reduced Catheter-Associated UTI Risk

A recent study conducted in Spain has revealed that utilising wet wipes for cleaning bedridden patients with catheters can significantly reduce the incidence of catheter-associated urinary tract infections (CAUTIs).

Researchers led by Irma Casas at the Germans Trias I Pujol University Hospital in Barcelona observed that compliance with inpatient hygiene protocols was particularly low in the cardiac surgery critical care unit, leading to higher rates of bacteriuria and CAUTIs among patients with indwelling urinary catheters.

To address this issue, an open-label, randomised controlled trial was carried out between January 2019 and February 2020. This study was published in Infection Control And Hospital Epidemiology. Patients who underwent cardiac surgery and met specific criteria were randomly assigned to one of two groups. The control group received traditional patient hygiene using water and soap, while the experimental group received dry hygiene with specialized wipes known as Prontosan wipes. These wipes possess decontaminating properties but do not act as antiseptics.

• The study involved a total of 170 patients, with 85 in each group. The results demonstrated a substantial reduction in CAUTIs among patients in the experimental group who received dry hygiene with wipes (5.9%, 95% CI: 2.2%-12.5%) compared to the control group (16.5%, 95% CI: 9.7%-25.5%).
  
• Multivariable analysis further confirmed that conventional hygiene was independently associated with a higher risk of CAUTI (OR = 4.1, 95% CI: 1.3-12.7).
• The majority of CAUTIs (60%) were associated with enterobacterial infections, although polymicrobial cultures were also observed (20%), with a higher frequency in the control group (75%).
• Most patients (94.1%) maintained skin integrity, and fewer patients in the dry hygiene group developed moisture-induced skin lesions compared to the conventional hygiene group (3.5% vs. 7.1%).

The study underscores the effectiveness of utilizing moistened wipes for patient hygiene, particularly in critical care units, as a means to reduce the incidence of CAUTIs and emphasises the cost-efficiency of preventive measures for improving patient outcomes and reducing the burden on the healthcare system.

Reference:

Castellà, L., Casas, I., Giménez, M., Reina, D., Sopena, N., García-Quesada, M.-J., & the Clinical Working Group. Hygiene with wet wipes in bedridden patients to prevent catheter-associated urinary tract infection in cardiac surgery: A randomized controlled trial. Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America,2023:1–4. https://doi.org/10.1017/ice.2023.178