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Am J Infect Control. 2014 Dec;42(12):1278-84. doi: 10.1016/j.ajic.2014.08.018. Epub 2014 Nov 25.

Meta-analysis on central line-associated bloodstream infections associated with a needleless intravenous connector with a new engineering design.

Author information

1
Department of Clinical Research, CareFusion, San Diego, CA. Electronic address: ying.tabak@carefusion.com.
2
Jason and Jarvis Associates, LLC, Hilton Head Island, SC.
3
Department of Clinical Research, CareFusion, San Diego, CA.
4
Department of Clinical Research, CareFusion, San Diego, CA; Division of Gastroenterology/Department of Medicine, Harvard Medical School, Boston, MA.

Abstract

BACKGROUND:

Intravenous needleless connectors (NCs) with a desired patient safety design may facilitate effective intravenous line care and reduce the risk for central line-associated bloodstream infection (CLA-BSI). We conducted a meta-analysis to determine the risk for CLA-BSI associated with the use of a new NC with an improved engineering design.

METHODS:

We reviewed MEDLINE, Cochrane Database of Systematic Reviews, Embase, ClinicalTrials.gov, and studies presented in 2010-2012 at infection control and infectious diseases meetings. Studies reporting the CLA-BSIs in patients using the positive-displacement NC (study NC) compared with negative- or neutral-displacement NCs were analyzed. We estimated the relative risk of CLA-BSIs with the study NC for the pooled effect using the random effects method.

RESULTS:

Seven studies met the inclusion criteria: 4 were conducted in intensive care units, 1 in a home health setting, and 2 in long-term acute care settings. In the comparator period, total central venous line (CL) days were 111,255; the CLA-BSI rate was 1.5 events per 1,000 CL days. In the study NC period, total CL days were 95,383; the CLA-BSI rate was 0.5 events per 1,000 CL days. The pooled CLA-BSI relative risk associated with the study NC was 0.37 (95% confidence interval, 0.16-0.90).

CONCLUSION:

The NC with an improved engineering design is associated with lower CLA-BSI risk.

KEYWORDS:

Bloodstream infection; Central line‚Äďassociated bloodstream infection; Meta-analysis; Needleless connector; Positive-displacement valve

PMID:
25465257
DOI:
10.1016/j.ajic.2014.08.018
[Indexed for MEDLINE]
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