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Published on: July 13, 2019
Antiseptic barrier cap effective in reducing central line-associated bloodstream infections: A systematic review and
Anne F Voor In 't Holt1, Onno K Helder2, Margreet C Vos1
1Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands.
Background:
Microorganisms can intraluminally access a central venous catheter via the catheter hub. The catheter hub should be appropriately disinfected to prevent central line-associated bloodstream infections (CLABSIs). However, compliance with the time-consuming manual disinfection process is low. An alternative is the use of an antiseptic barrier cap, which cleans the catheter hub by continuous passive disinfection.
Objective:
To compare the effects of antiseptic barrier cap use and manual disinfection on the incidence of CLABSIs.
Design:
Systematic review and meta-analysis.
Methods:
We systematically searched Embase, Medline Ovid, Web-of-science, CINAHL EBSCO, Cochrane Library, PubMed Publisher and Google Scholar until May 10, 2016. The primary outcome, reduction in CLABSIs per 1000 catheter-days, expressed as an incidence rate ratio (IRR), was analyzed with a random effects meta-analysis. Studies were included if 1) conducted in a hospital setting, 2) used antiseptic barrier caps on hubs of central lines with access to the bloodstream and 3) reported the number of CLABSIs per 1000 catheter-days when using the barrier cap and when using manual disinfection.
Results:
A total of 1537 articles were identified as potentially relevant and after exclusion of duplicates, 953 articles were screened based on title and abstract; 18 articles were read full text. Eventually, nine studies were included in the systematic review, and seven of these nine in the random effects meta-analysis. The pooled IRR showed that use of the antiseptic barrier cap was effective in reducing CLABSIs (IRR=0.59, 95% CI=0.45-0.77, P<0.001).
Conclusions:
Use of an antiseptic barrier cap is associated with a lower incidence CLABSIs and is an intervention worth adding to central-line maintenance bundles.
Insights
Antiseptic barrier caps significantly reduce central line-associated bloodstream infections (CLABSIs) compared to manual disinfection. This intervention is a valuable addition to catheter maintenance bundles for preventing infections.
Area of Science:
- Infectious Diseases
- Medical Device Safety
- Healthcare Epidemiology
Background:
- Microbial contamination of central venous catheters (CVCs) can occur via the catheter hub, leading to CLABSIs.
- Manual disinfection of CVC hubs is crucial but suffers from low compliance due to its time-intensive nature.
- Antiseptic barrier caps offer a passive disinfection method for CVC hubs, potentially improving compliance and reducing infection risk.
Purpose of the Study:
- To evaluate the efficacy of antiseptic barrier caps in reducing CLABSIs.
- To compare the incidence of CLABSIs between antiseptic barrier cap use and traditional manual disinfection methods.
Main Methods:
- A systematic review and meta-analysis of relevant studies was conducted.
- Searches were performed across multiple databases (Embase, Medline, Web-of-science, etc.) up to May 2016.
- The primary outcome, CLABSI incidence rate ratio (IRR), was analyzed using random-effects meta-analysis.
Main Results:
- The meta-analysis included seven studies, encompassing data from the systematic review of nine studies.
- The pooled incidence rate ratio (IRR) demonstrated a significant reduction in CLABSIs with antiseptic barrier cap use (IRR=0.59, 95% CI=0.45-0.77, P<0.001).
Conclusions:
- The use of antiseptic barrier caps is associated with a lower incidence of CLABSIs.
- Antiseptic barrier caps represent a promising intervention to enhance central line maintenance bundles.
- Implementing antiseptic barrier caps can contribute to improved patient safety by reducing healthcare-associated infections.
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