title: 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.
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.
authors.affiliation: Center for Quality Outcomes, West Virginia University Hospitals, Morgantown, WV 26506, USA. sweetm@wvuhealthcare.com
authors.forename: Michael A
authors.initials: MA
authors.lastname: Sweet
authors.forename: Aaron
authors.initials: A
authors.lastname: Cumpston
authors.forename: Frank
authors.initials: F
authors.lastname: Briggs
authors.forename: Michael
authors.initials: M
authors.lastname: Craig
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hamadani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000438:Alcohols / Q000008:administration & dosage; D001769:Blood / Q000382:microbiology; D055499:Catheter-Related Infections / Q000517:prevention & control*; D004202:Disinfectants / Q000008:administration & dosage; D004203:Disinfection / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D016522:Oncology Service, Hospital; D011312:Pressure; D018805:Sepsis / Q000517:prevention & control; D062606:Tertiary Care Centers; D062666:Vascular Access Devices / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000438:Alcohols; D004202:Disinfectants