Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: A randomized controlled trial

Risk factors for central venous catheter-related bloodstream infection: A 1073-patient study

“…Yebenes et al 2 described that in critically ill patients, a needle-free connector prevented CR-BSI. McDonald et al, 5 however, reported an increased risk of CR-BSI associated with a needleless device in a pediatric ICU.…”

“…Among the studies carried out to reduce catheter-related bloodstream infection (CR-BSI), the microbiological data are supportive, 1 but the clinical data remain controversial 2,3 in regard to the use of a closed connector in the central venous (CV) line. Because of the possible seasonal fl uctuations in the incidence of CR-BSI, before and after the customary changes of staff in April in Japan, we carried out a 2-year study, before and after implementation of the use of closed needleless connectors (NCs) in a teaching hospital.…”

Is there evidence for recommending needleless closed catheter access systems in guidelines? A systematic review of randomized controlled trials

“…2,[9][10][11][12][13] Out of the six studies, one paper was excluded after reading the whole article. 2 The reason for exclusion was that the study was not randomized.…”

Lost in Translation

“…28 " 32 Most of these studies have been retrospective and uncontrolled, and suboptimal usage of the device, rather than the device itself, may have been responsible for the increased incidence of BSI in some settings. The few randomized trials comparing needleless connection devices with standard connectors have found relative reductions in BSI rates with the use of the needleless device under study, ranging from 84% to 86%, 33,34 and the most recent CDC HICPAC guideline on prevention of IVDR BSI concludes that, "when used properly, needleless devices do not adversely affect the incidence of BSI." 18<pll) In this issue of the journal, Maragakis et al 8 describe a sharp increase in BSI rates following introduction of a new needleless connector with a positive-pressure mechanical valve designed to prevent reflux of blood into the catheter.…”