Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector

A randomized controlled trial

Yébenes, Juan C. PhD, MD
Vidaur, Loreto MD
Serra-Prat, Mateu MD, MPH
Sirvent, Josep M. PhD, MD
Batlle, Jordi MD
Motje, Montserrat MD
Bonet, Alfons MD
Palomar, Mercedes PhD, MD

^aIntensive Care Unit, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
^bResearch Unit, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain
^cMicrobiological Laboratory, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
^dIntensive Care Unit, Hospital Vall d'Hebrón, Barcelona, Spain.

Reprint requests: Juan Carlos Yébenes, Intensive Care Unit, Hospital de Mataró, Carretera de Cirera s/n, 08304, Mataró, Barcelona, Spain; E-mail: [email protected].

Desinfectable needle-free connectors were provided by Alaris Medical Systems (San Diego, Calif) without charge.

AJIC: American Journal of Infection Control 32(5):p 291-295, August 2004.

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.