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Int J Nurs Stud. 2017 Apr;69:34-40. doi: 10.1016/j.ijnurstu.2017.01.007. Epub 2017 Jan 22.

Antiseptic barrier cap effective in reducing central line-associated bloodstream infections: A systematic review and meta-analysis.

Author information

1
Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands.
2
Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital,, Rotterdam, The Netherlands.
3
Department of Obstetrics and Gynecology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
4
Institute of Health Policy and Management (iBMG), Erasmus University Rotterdam, The Netherlands.
5
University Medical Center Utrecht, Wilhelmina Children's Hospital, Clinical Health Science, University Utrecht, The Netherlands.
6
Department of Intensive Care, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: w.ista@erasmusmc.nl.

Abstract

BACKGROUND:

Microorganisms can intraluminally access a central venous catheter via the catheter hub. The catheter hub should be appropriately disinfected to prevent central line-associated bloodstream infections (CLABSIs). However, compliance with the time-consuming manual disinfection process is low. An alternative is the use of an antiseptic barrier cap, which cleans the catheter hub by continuous passive disinfection.

OBJECTIVE:

To compare the effects of antiseptic barrier cap use and manual disinfection on the incidence of CLABSIs.

DESIGN:

Systematic review and meta-analysis.

METHODS:

We systematically searched Embase, Medline Ovid, Web-of-science, CINAHL EBSCO, Cochrane Library, PubMed Publisher and Google Scholar until May 10, 2016. The primary outcome, reduction in CLABSIs per 1000 catheter-days, expressed as an incidence rate ratio (IRR), was analyzed with a random effects meta-analysis. Studies were included if 1) conducted in a hospital setting, 2) used antiseptic barrier caps on hubs of central lines with access to the bloodstream and 3) reported the number of CLABSIs per 1000 catheter-days when using the barrier cap and when using manual disinfection.

RESULTS:

A total of 1537 articles were identified as potentially relevant and after exclusion of duplicates, 953 articles were screened based on title and abstract; 18 articles were read full text. Eventually, nine studies were included in the systematic review, and seven of these nine in the random effects meta-analysis. The pooled IRR showed that use of the antiseptic barrier cap was effective in reducing CLABSIs (IRR=0.59, 95% CI=0.45-0.77, P<0.001).

CONCLUSIONS:

Use of an antiseptic barrier cap is associated with a lower incidence CLABSIs and is an intervention worth adding to central-line maintenance bundles.

KEYWORDS:

Antiseptic barrier cap; Central line-associated bloodstream infections; Infection control; Meta-analysis; Systematic review

PMID:
28130997
DOI:
10.1016/j.ijnurstu.2017.01.007
[Indexed for MEDLINE]

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