Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: a randomized controlled trial.
OBJECTIVE
The aim of this study was to assess the efficacy of a disinfectable, needle-free connector in the prophylaxis of catheter-related bloodstream infection.


METHODS
A randomized controlled trial was performed in a polyvalent intensive care unit. Patients who needed multilumen central venous catheters were randomly assigned to a study or a control group. All catheters were inserted and manipulated according to the Centers for Disease Control and Prevention (CDC) recommendations. Study group patients were equipped with catheters with disinfectable, needle-free connectors whereas control group patients were equipped with catheters with 3-way stopcocks. Two peripheral blood cultures and a semiquantitative culture of the catheter tip were performed on removal of the catheter.


RESULTS
The study included 243 patients, with a total of 278 central venous catheters. The catheters' mean insertion duration was 9.9 days. Both groups were comparable regarding patient and catheter characteristics. Incidence rate of catheter-related bloodstream infection was 0.7 per 1000 days of catheter use in the study group, compared with 5.0 per 1000 days of catheter use in the control group (P=.03).


CONCLUSIONS
To add a disinfectable, needle-free connector to the CDC recommendations reduces the incidence of catheter-related bloodstream infection in critically ill patients with central venous catheters.
Intensive Care Unit, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain. jcyebenes@csm.scs.es
Juan C
JC
Yébenes
Loreto
L
Vidaur
Mateu
M
Serra-Prat
Josep M
JM
Sirvent
Jordi
J
Batlle
Montserrat
M
Motje
Alfons
A
Bonet
Mercedes
M
Palomar
D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology; D016638:Critical Illness; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018805:Sepsis / Q000382:microbiology / Q000517:prevention & control*; D018709:Statistics, Nonparametric