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


Journal

American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854

Informations de publication

Date de publication:
05 2021
Historique:
received: 19 06 2020
revised: 31 08 2020
accepted: 02 09 2020
pubmed: 24 9 2020
medline: 25 6 2021
entrez: 23 9 2020
Statut: ppublish

Résumé

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. 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. 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). The introduction of ABCs in this high-risk population did not significantly alter CLABSI rates.

Sections du résumé

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.

Identifiants

pubmed: 32966854
pii: S0196-6553(20)30859-2
doi: 10.1016/j.ajic.2020.09.002
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

586-592

Informations de copyright

Copyright © 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Rebeca Cruz-Aguilar (R)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany.

Jonathan Carney (J)

Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.

Vanessa Mondaini (V)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany.

Maria J G T Vehreschild (MJGT)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany; Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany; German Centre for Infection Research (DZIF), Bonn, Cologne, Germany. Electronic address: maria.vehreschild@kgu.de.

Matas Griskaitis (M)

Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

Jon Salmanton-García (J)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany.

Boris Böll (B)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany.

Matthias Kochanek (M)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany.

Harald Seifert (H)

German Centre for Infection Research (DZIF), Bonn, Cologne, Germany; Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany.

Lena M Biehl (LM)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany; German Centre for Infection Research (DZIF), Bonn, Cologne, Germany.

Fedja Farowski (F)

University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany; Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany; German Centre for Infection Research (DZIF), Bonn, Cologne, Germany.

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