title: Use of Disinfection Cap to Reduce Central-Line-Associated Bloodstream Infection and Blood Culture Contamination Among Hematology-Oncology Patients.
abstract: OBJECTIVE
  In this study, we examined the impact of routine use of a passive disinfection cap for catheter hub decontamination in hematology-oncology patients.
  
  
  METHODS
  A tertiary care cancer center in New York City.
  
  
  METHODS
  In this multiphase prospective study, we used 2 preintervention phases (P1 and P2) to establish surveillance and baseline rates followed by sequential introduction of disinfection caps on high-risk units (HRUs: hematologic malignancy wards, hematopoietic stem cell transplant units and intensive care units) (P3) and general oncology units (P4). Unit-specific and hospital-wide hospital-acquired central-line-associated bloodstream infection (HA-CLABSI) rates and blood culture contamination (BCC) with coagulase negative staphylococci (CONS) were measured.
  
  
  RESULTS
  Implementation of a passive disinfection cap resulted in a 34% decrease in hospital-wide HA-CLABSI rates (combined P1 and P2 baseline rate of 2.66-1.75 per 1,000 catheter days at the end of the study period). This reduction occurred only among high-risk patients and not among general oncology patients. In addition, the use of the passive disinfection cap resulted in decreases of 63% (HRUs) and 51% (general oncology units) in blood culture contamination, with an estimated reduction of 242 BCCs with CONS. The reductions in HA-CLABSI and BCC correspond to an estimated annual savings of $3.2 million in direct medical costs.
  
  
  CONCLUSIONS
  Routine use of disinfection caps is associated with decreased HA-CLABSI rates among high-risk hematology oncology patients and a reduction in blood culture contamination among all oncology patients.
authors.affiliation: 1Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Mini
authors.initials: M
authors.lastname: Kamboj
authors.affiliation: 1Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Rachel
authors.initials: R
authors.lastname: Blair
authors.affiliation: 1Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Natalie
authors.initials: N
authors.lastname: Bell
authors.affiliation: 1Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Crystal
authors.initials: C
authors.lastname: Son
authors.affiliation: 3Department of Medicine,Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Yao-Ting
authors.initials: YT
authors.lastname: Huang
authors.affiliation: 2Department of Nursing,Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Mary
authors.initials: M
authors.lastname: Dowling
authors.affiliation: 5Department of Epidemiology and Biostatistics,Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Allison
authors.initials: A
authors.lastname: Lipitz-Snyderman
authors.affiliation: 1Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Janet
authors.initials: J
authors.lastname: Eagan
authors.affiliation: 1Infection Control and Infectious Disease Service Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Kent
authors.initials: K
authors.lastname: Sepkowitz
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000191:economics / Q000379:methods*; D009369:Neoplasms / Q000628:therapy; D009519:New York City / Q000453:epidemiology; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D062606:Tertiary Care Centers