Efficacy of three different valve systems of needle-free closed connectors in avoiding access of microorganisms to endovascular catheters after incorrect handling*

Yébenes, Juan Carlos; Delgado, Maria; Sauca, Goretti; Serra‐Prat, Mateu; Solsona, Manel; Almirall, Jordi; Capdevila, J.A.; Balanzó, Xavier

doi:10.1097/ccm.0b013e318183effb

Cited by 34 publications

(20 citation statements)

References 15 publications

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“…Disinfection prior to injection was associated with reduced bacterial contamination [0% (0/152)] with an absolute risk reduction of 3.2% (95% CI 0.5%-7.4%) of bacterial injection. Thus, this study clearly shows that catheter hub disinfection prior to injection is necessary in the clinical environment [18].…”

Section: Key Pointsmentioning

confidence: 95%

Infection control in the operating room

Loftus

2016

Current Opinion in Anaesthesiology

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Recent work has led to the development of evidence-based hand hygiene, environmental cleaning, patient decolonization, and intravascular catheter design and handling improvement strategies. Evidence suggests that a best practice for postoperative infection control is a multimodal program that utilizes these interventions to target patient, provider, and environmental reservoirs in parallel. The development of novel diagnostic tools for targeted attenuation of hyper virulent, transmissible and resistant strains/strain characteristics is indicated to improve patient decolonization efforts.

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Section: Key Pointsmentioning

confidence: 95%

Infection control in the operating room

Loftus

2016

Current Opinion in Anaesthesiology

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“…There are several studies comparing such devices regarding their internal mechanisms and their displacement. Overall, closed system connectors with split septum and neutral displacement have been demonstrated to be the safest in terms of microorganisms penetration impediment [69,95,96]. These needle-free components should be changed at least as frequently as the administration set, as it has been demonstrated no benefit to changing them more frequently than every 96 hours [97].…”

Section: Closed System Connectors and Disinfectionmentioning

confidence: 95%

“…These needle-free components should be changed at least as frequently as the administration set, as it has been demonstrated no benefit to changing them more frequently than every 96 hours [97]. Moreover, they must be cleaned before use with appropriate disinfectants to prevent microorganisms transmission [96]. Disinfect needleless connectors with 2 % alcoholic chlorhexidine demonstrated a reduction in the internal microbial load [98].…”

Section: Closed System Connectors and Disinfectionmentioning

confidence: 98%

Innovative Strategies for Preventing Central-Line Associated Infections

Bouza

Guembe

Pérez‐Granda

2013

Curr Treat Options Infect Dis

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Opinion statementIn recent years, healthcare associated infections (HAIs), and central line-associated bloodstream infections in particular (CLABSI), are being viewed as "preventable" events. It has been estimated that up to 70 % of CLABSI episodes may be preventable with the implementation of evidence-based strategies pretending to reach the zero incidence. The most effective procedures, which have demonstrated to reduce significantly CLABSI rates, are preventive bundles, which consists of a set of measures to be carried out during both catheter insertion and maintenance. These measures are mainly the following: implementing continuous education and training of healthcare personnel workers, using maximal sterile barrier precautions during insertion, performing skin disinfection with 2 % alcoholic chlorhexidine, avoiding the femoral site, and removing unnecessary catheters. However, these strategies have been performed mainly in the intensive care units (ICUs) with much less emphasis and efforts in non-ICU wards. There is also a need to introduce other novel strategies to reduce the CLABSI rates such as using catheter lock antiseptic solutions, using antiseptic impregnated sponges and dressings, designating a surveillance nurse to monitor central lines, or keeping a record of the insertion and maintenance procedures using a checklist.

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“…In this study, all catheters were equipped with a disinfectable needlefree closed connector system. If used properly, this may decrease the risk of endoluminal CRBSI (29). Finally, the sonication technique may not be able to remove microorganisms from the endoluminal biofilm sufficiently.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Roll Plate Method to the Sonication Method To Diagnose Catheter Colonization and Bacteremia in Patients with Long-Term Tunnelled Catheters: a Randomized Prospective Study

et al. 2009

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Diagnosing catheter-related bloodstream infection (CRBSI) still often involves tip culture. The conventional method is the semiquantitative roll plate method. However, the use of a quantitative sonication technique could have additional value, as it may detect endoluminal microorganisms more easily. Because endoluminal infection tends to occur in long-term central venous catheters, we compared both techniques for patients with long-term tunnelled catheters. For 313 consecutive Hickman catheter tips from 279 hematological patients, colonization detection rates were compared by performing both techniques in a random order, using conventional detection cutoffs. Additionally, for the subgroup of patients with clinical suspicion of CRBSI (n ‫؍‬ 89), the diagnostic values of both techniques were compared. The overall tip colonization rate was 25%. For each technique, the detection rate tended to be better if that technique was performed first. The diagnostic performance for the subgroup of patients with clinical suspicion of CRBSI was limited and not different for both methods. Sensitivity and specificity were 45% and 84%, respectively, for sonication versus 35% and 90%, respectively, for the roll plate technique. The fact that 35 of 40 patients with CRBSI received antimicrobial therapy before catheter removal and tip culture, in an attempt to salvage the catheter, may partly explain this poor performance. No differences were observed when catheters were stratified according to in situ time below or above the median of 4 weeks. The sonication culture technique was not better than the roll plate method to diagnose tip colonization or CRBSI in patients with long-term tunnelled catheters.

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Efficacy of three different valve systems of needle-free closed connectors in avoiding access of microorganisms to endovascular catheters after incorrect handling*

Abstract: The barrier effect of disinfectable needle-free closed connectors is adversely affected by incorrect handling, the quantity of external valve colonization, and the valve design.

Cited by 34 publications

References 15 publications

Infection control in the operating room

Infection control in the operating room

Innovative Strategies for Preventing Central-Line Associated Infections

Comparison of the Roll Plate Method to the Sonication Method To Diagnose Catheter Colonization and Bacteremia in Patients with Long-Term Tunnelled Catheters: a Randomized Prospective Study

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