title: Prevention of catheter-related sepsis during parenteral nutrition: effect of a new connection device.
abstract: A prospective study was carried out to determine the clinical effect of a newly devised catheter connection method (I system) and piggyback access system. Previous studies have demonstrated that the I system avoided bacterial contamination in vitro during tubing change that Luer-Lock connectors did not. The purpose of this study was to investigate the ability of this device coupled with a new closed-system piggyback technique for multipurpose access to reduce catheter-related sepsis in clinical practice. Two hundred and thirty patients receiving total parenteral nutrition were divided into two groups. Group I (n = 106) used the I system connector and group L (n = 124) used a Luer-Lock connector. Catheters in both groups were used for multipurpose access for infusion and blood sampling. In group L, a three-way stopcock and/or pig-gyback system was used for multiple access. In group I, a newly designed closed-system piggyback was used. The incidence of catheter-related sepsis was significantly lower in group I (1.89%/catheter) than in group L (12.10%/catheter) (p < .01, chi 2 analysis), and the average duration of use of each catheter was significantly longer in group I than in Group L (p < .01 by generalized Wilcoxon test). The results of this clinical study suggest that the newly designed connection method and piggyback access system are able to reduce catheter-related sepsis.
authors.affiliation: First Department of Surgery, Osaka University Medical School, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
authors.forename: R
authors.initials: R
authors.lastname: Nezu
authors.forename: H
authors.initials: H
authors.lastname: Matsuda
authors.forename: M
authors.initials: M
authors.lastname: Fujii
authors.forename: S
authors.initials: S
authors.lastname: Nakai
authors.forename: M
authors.initials: M
authors.lastname: Wasa
authors.forename: Y
authors.initials: Y
authors.lastname: Takagi
authors.forename: A
authors.initials: A
authors.lastname: Okada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000517:prevention & control*; D002177:Candidiasis / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004866:Equipment Contamination; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000295:instrumentation; D011446:Prospective Studies