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Published on: September 21, 2015

Maximal sterile barrier precautions do not reduce catheter-related bloodstream infections in general surgery units: a

Yoshinori Ishikawa1, Teruo Kiyama, Yoshio Haga

  • 1Department of Surgery, Nippon Medical School, Tokyo, Japan.

Annals of Surgery
|March 13, 2010
PubMed
Abstract

Insights

Maximal sterile barrier precautions (MSBPs) did not show a significant benefit in preventing catheter-related bloodstream infections (CRBSIs) compared to standard precautions in surgical patients. Further large-scale trials are needed to confirm these findings for central venous catheter insertions.

Area of Science:

  • Infectious Diseases
  • Surgical Patient Care
  • Healthcare-Associated Infections

Background:

  • Previous evidence on maximal sterile barrier precautions (MSBPs) for preventing catheter-related bloodstream infections (CRBSIs) primarily comes from a single-center trial focusing on chemotherapy outpatients.
  • The generalizability of MSBPs' effectiveness to diverse patient populations, such as those in general surgical units, remains uncertain.
  • This study addresses the need for evidence in surgical settings, where central venous catheter (CVC) use is common.

Purpose of the Study:

  • To evaluate the efficacy of maximal sterile barrier precautions (MSBPs) versus standard sterile barrier precautions (SSBP) in preventing CRBSIs during central venous catheter (CVC) insertion.
  • To assess the impact of MSBPs on overall catheter-related infections in patients within general surgical units.
  • To provide robust data for clinical practice guidelines regarding CVC insertion protocols.

Main Methods:

  • A multi-center randomized controlled trial involving 424 patients undergoing CVC insertion in surgical units across 9 Japanese medical centers.
  • Patients were randomized to either MSBP (n=211) or SSBP (n=213) groups.
  • Data collection focused on CRBSI rates, other catheter-related infections, and duration of catheterization.

Main Results:

  • No statistically significant difference in CRBSI rates between the MSBP and SSBP groups (2.4% vs. 2.8%, P=0.77).
  • CRBSI rates per 1000 catheter days were similar: 1.5 for MSBP and 1.6 for SSBP.
  • Overall catheter-related infection rates also showed no significant difference (3.8% vs. 3.3%, P=0.78).

Conclusions:

  • This larger study could not confirm the superior efficacy of MSBPs over SSBP in preventing CRBSIs in general surgical patients.
  • The findings suggest that MSBPs may not offer additional benefits compared to SSBP in this specific patient population.
  • Further large-scale randomized controlled trials or meta-analyses are warranted to definitively establish the role of MSBPs in CRBSI prevention.

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