The microbiological and physical properties of catheters for intermittent catheterization: A systematic review on the impact of reuse and cleaning methods
Bibliographic record
Abstract
Abstract This systematic review provides an up to date and comprehensive summary of the clinical evidence of the effectiveness of various cleaning methods of intermittent catheterization that have been proposed to prepare catheters for reuse. This systematic review is registered at PROSPERO (registration number: CRD42020176065). A key word search of Medline (OVID), Excerpta Medica dataBASE (EMBASE, OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL), in addition to manual searches of retrieved articles, was undertaken to identify all English, Russian and German language literature evaluating the effectiveness of various cleaning methods of intermittent catheterization. Studies selected for review included analytical experimental, prospective cohort, cross-sectional and case series study designs. Prospective cleaning methods analyzed included heat-based sterilization, chemical cleaning solutions, mechanical abrasion, photocatalytic sterilization, and combined methods. Studies that failed to assess the bacterial colonization or physical properties of catheters following cleaning were excluded. In total, 12 studies (i.e. 9 analytical experimental, 1 cohort study, 1 cross-sectional and 1 case series) were included. Two cleaning methods were identified as likely being most promising: five-minute submersion in 70% alcohol and the “Milton method”. Each eliminated bacterial colonization without affecting the physical properties of the catheters. All other cleaning methods were either non-bactericidal or caused gross visual or microscopic damage to the catheters, rendering their reuse unsafe. Additional higher-powered studies confirming the safety and efficacy of these cleaning methods must be obtained before we would feel comfortable challenging current clinical recommendations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.056 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.009 |
| Bibliometrics | 0.010 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".