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Impact of alcohol-impregnated port protectors and needleless neutral pressure connectors on central line-associated bloodstream infections and contamination of blood cultures in an inpatient oncology unit. Am J Infect Control 2012 Dec;40(10):931-4

Date

05/12/2012

Pubmed ID

22575286

DOI

10.1016/j.ajic.2012.01.025

Scopus ID

2-s2.0-84870417336 (requires institutional sign-in at Scopus site)   65 Citations

Abstract

BACKGROUND: A major risk factor for the development of bloodstream infection is the presence of a central venous catheter (CVC), especially in immunocompromised patients. CVC hub contamination is a risk factor for central line-associated bloodstream infection (CLABSI).

METHODS: This observational before-after trial in a tertiary care hospital's oncology unit included adult patients with a CVC. During the intervention period, the practice of central line hub care was changed from cleaning with alcohol wipes to using alcohol-impregnated port protectors. To accommodate the protectors, the needless hubs were changed to a neutral pressure connector. The intervention period (January-July 2010) was compared with a historical control (January-December 2009).

RESULTS: A total of 3,005 central line-days and 1 CLABSI (a rate of 0.3 infections/1,000 central line-days) were documented during the intervention period, compared with 6,851 central line-days and 16 CLABSIs (2.3 infections/1,000 central line-days) during the control period (relative risk, 0.14; 95% confidence interval [CI], 0.02-1.07; P = .03). The rate of contaminated blood cultures (CBCs) from central lines was 2.5% (17 of 692) during the control period, but only 0.2% (1 of 470) during the intervention period (relative risk, 0.09; 95% CI, 0.01-0.65; P = .002).

CONCLUSIONS: The implementation of alcohol-impregnated port protectors and needleless neutral pressure connectors significantly reduced the rates of CLABSIs and CBCs in our oncology patient population.

Author List

Sweet MA, Cumpston A, Briggs F, Craig M, Hamadani M

Author

Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Alcohols
Blood
Catheter-Related Infections
Disinfectants
Disinfection
Female
Humans
Inpatients
Male
Middle Aged
Oncology Service, Hospital
Pressure
Sepsis
Tertiary Care Centers
Vascular Access Devices
Young Adult