6533b873fe1ef96bd12d587f

RESEARCH PRODUCT

A quality improvement study on the reduction of central venous catheter-associated bloodstream infections by use of self-disinfecting venous access caps (STERILE)

Vanessa MondainiBoris BöllMaria J G T VehreschildMaria J G T VehreschildHarald SeifertFedja FarowskiJonathan CarneyMatthias KochanekMatas GriskaitisRebeca Cruz-aguilarJon Salmanton-garcíaLena M Biehl

subject

Catheterization Central Venousmedicine.medical_specialtyEpidemiologymedicine.drug_classmedicine.medical_treatmentPopulationBacteremiaSingle Center03 medical and health sciences0302 clinical medicineAntisepticSepsisInternal medicinemedicineCentral Venous CathetersHumansProspective Studies030212 general & internal medicineeducationRetrospective Studies0303 health scienceseducation.field_of_study030306 microbiologybusiness.industryHealth PolicySignificant differenceHazard ratioPublic Health Environmental and Occupational HealthQuality ImprovementVenous accessCatheterInfectious DiseasesCatheter-Related InfectionsbusinessCentral venous catheter

description

Background Contamination of the catheter hub is an important source of central line-associated bloodstream infections (CLABSI); catheter hub caps incorporating a 70% isopropyl alcohol aim are designed to reduce contamination and hence CLABSI rates. Supporting data in high-risk hematological and oncological patients on the clinical effectiveness of this approach are sparse. Methods We conducted a before-after single center study accompanying the introduction of such caps at our department. Retrospective data from the year prior to the introduction were compared to 1 year of prospective data. Results The control and antiseptic barrier cap (ABC) groups consisted of 309 and 289 patients presenting a CLABSI rate of 15.28 and 10.38 per 1,000 catheter days (P= .042), respectively. However, after multivariate analysis, ABCs were not identified as a statistically significant independent protective factor for the occurrence of CLABSI (hazard ratio 0.69, P= .120). There was no significant difference between the groups with respect to time to CLABSI (P= .681), nor the proportion of catheters removed due to suspicion of infection (P= .076). Conclusions The introduction of ABCs in this high-risk population did not significantly alter CLABSI rates.

https://doi.org/10.1016/j.ajic.2020.09.002