Do positive fluid-displacement Luer-activated devices increase infection rates? The jury is still out

Luer-activated devices (LADs) are needleless connectors that allow access to intravenous systems. There have been anecdotal reports that one type of LAD, which uses a positive fluid-displacement (PFD) design, has been associated with elevated rates of catheter-related bloodstream infections (CR-BSIs). As yet, however, there isn't enough scientific evidence to conclusively demonstrate a link between PFD LADs and CR-BSIs. (Shown at right are three examples of PFD LADs. No one design, model, or manufacturer of these devices has been particularly associated with CR-BSIs.) In this article, we explain why detecting the problem can be so difficult and outline some steps healthcare facilities can take to identify LAD-related infections. And we describe a survey we've placed on our Web site to collect data on LADs and infection rates, including changes in rates following a change of device type.