title: Prospective observational study on central line-associated bloodstream infections and central venous catheter occlusions using a negative displacement connector with an alcohol disinfecting cap.
abstract: BACKGROUND
  Major complications of central venous catheter (CVC) use include bloodstream infection and occlusion. We performed a prospective, observational study to determine the rate of central line-associated bloodstream infection (CLABSI) and CVC occlusion using a negative displacement connector with an alcohol disinfecting cap.
  
  
  METHODS
  Patients were followed from the time of CVC insertion through 2 days after removal, at the time of hospital discharge if there was no documentation of removal, or 90 days after the insertion of the CVC if it was not removed. CLABSI was defined using National Healthcare Safety Network criteria. Data for evidence of lumen occlusions were extracted from the electronic health record. Direct observations were performed to assess adherence to hospital policy regarding CVC insertion practice.
  
  
  RESULTS
  A total of 2,512 catheters from 2,264 patients were enrolled for this study. There were 21 CLABSIs (0.84%; 95% confidence interval [CI], 0.48%-1.19%; 0.62 per 1,000 line days) and 378 occlusions (15.05%; 95% CI, 13.65%-16.45%; 11.23 per 1,000 line days). Eighty-five direct observations demonstrated insertion protocol adherence in 881 of 925 (95.24%; 95% CI, 93.87%-96.61%) measured criteria.
  
  
  CONCLUSIONS
  Lines placed following a standardized protocol using a negative displacement connector with an alcohol cap have low rates of infection compared with historically published findings. We also established that the occlusion rate is >15-fold the CLABSI rate.
authors: NorthShore University Health System, Evanston, IL. Electronic address: ppatel@northshore.org.
authors: Parul A
authors: PA
authors: Patel
authors: NorthShore University Health System, Evanston, IL.
authors: Susan
authors: S
authors: Boehm
authors: NorthShore University Health System, Evanston, IL.
authors: Ying
authors: Y
authors: Zhou
authors: NorthShore University Health System, Evanston, IL.
authors: Catherine
authors: C
authors: Zhu
authors: NorthShore University Health System, Evanston, IL.
authors: Kari E
authors: KE
authors: Peterson
authors: NorthShore University Health System, Evanston, IL.
authors: Althea
authors: A
authors: Grayes
authors: NorthShore University Health System, Evanston, IL; University of Chicago Pritzker School of Medicine, Chicago, IL.
authors: Lance R
authors: LR
authors: Peterson
mesh_terms: D000438:Alcohols / Q000008:administration & dosage*; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000453:epidemiology*
chemical_list: D000438:Alcohols; D000890:Anti-Infective Agents
keywords: CLABSI; Clots; Negative displacement connector