Antiseptic barrier caps to prevent central line-associated bloodstream infections: A systematic review and meta-analysis

Gillis, Veerle ELM; Es, Marijn J van; Wouters, Yannick; Wanten, Geert

doi:10.1016/j.ajic.2022.09.005

Cited by 6 publications

(6 citation statements)

References 43 publications

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“…To reduce this comorbidity, the most recent clinical evidence supports the use of NCs and ABCs for passive and continuous disinfection of NCs. 18 In this study, we showed that isopropanol can leak from the ABCs to the NC as a function of time, posing concerns about their use. We determined that the brand of NCs used was the most important parameter in this phenomenon.…”

Section: Discussionmentioning

confidence: 83%

“…4). 18 However, the choice of the disinfection method used, whether active or passive, must also take into account the superiority of ABC in terms of reducing the risk of CRBSI compared to isopropanol-soaked wipes. 18 This study had several limitations.…”

Section: Bbraun Safeflow®mentioning

confidence: 99%

“…18 However, the choice of the disinfection method used, whether active or passive, must also take into account the superiority of ABC in terms of reducing the risk of CRBSI compared to isopropanol-soaked wipes. 18 This study had several limitations. First, this was an in vitro study, and it would be interesting to confirm these results on patients exposed to ABCs.…”

Section: Bbraun Safeflow®mentioning

confidence: 99%

“…15,16 Overall, available evidence suggests that ABCs are effective, safe, easy to use, and cost-effective in reducing CRBSIs compared with isopropanol wipes in adults. 17,18 To the best of our knowledge, no cases of isopropanol intoxication have been reported with the use of an ABC on a NC. However, in 2 recent studies, isopropanol contained in the ABCs leaked into the NC, raising safety questions about potential isopropanol exposure to patients during routine care, particularly in a pediatric and neonatal intensive care settings.…”

mentioning

confidence: 98%

“…15,16 Overall, available evidence suggests that ABCs are effective, safe, easy to use, and cost-effective in reducing CRBSIs compared with isopropanol wipes in adults. 17,18…”

mentioning

confidence: 99%

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In vitro assessment of isopropanol leakage from antiseptic barrier caps into commonly used needleless connectors

Boissière,

Bacle,

Pelletier

et al. 2024

Infect. Control Hosp. Epidemiol.

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Background: Needleless connectors (NCs) can be disinfected using antiseptic barrier caps (ABCs) to reduce the risk of catheter-related bloodstream infections. However, recent evidence suggests that isopropanol can leak from the ABC into the NC, posing concern about their safe use. We sought to determine in vitro which ABC and NC parameters influence the leakage of isopropanol through the infusion circuit. Methods: We assessed 13 NCs and 4 ABCs available in the European market. In vitro circuits consisting of an isopropanol cap, a NC, and an 11-cm catheter line were created. The circuits were left in place for 1 to 7 days at room temperature to assess the kinetics of isopropanol leakage. Isopropanol content in ABC and in circuit flushing solutions (5 mL NaCl 0.9%) after exposure to the cap were measured using gas chromatography with a flame ionization detector. Results: The leakage of isopropanol from the cap to the NC was dependent on the NC, but not the cap. The NC mechanism did not predict the leakage of isopropanol. The Q-Syte NC exhibited the most isopropanol leakage (7.01±1.03 mg and 28.32±2.62 mg at 24 hours and 7 days, respectively), whereas the Caresite NC had the lowest isopropanol leakage at 7 days (1.69±0.01 mg). Conclusion: The use of isopropanol ABCs can cause isopropanol leakage into the catheter circuit according to NC parameters. Caution should be exercised when using these devices, especially in the pediatric and neonatal population.

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Section: Discussionmentioning

confidence: 83%

Section: Bbraun Safeflow®mentioning

confidence: 99%

Section: Bbraun Safeflow®mentioning

confidence: 99%

mentioning

confidence: 98%

“…15,16 Overall, available evidence suggests that ABCs are effective, safe, easy to use, and cost-effective in reducing CRBSIs compared with isopropanol wipes in adults. 17,18…”

mentioning

confidence: 99%

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