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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Antiseptic chamber-containing hub reduces central venous catheter-related infection: a prospective, randomized study
Cristóbal León1, Francisco Alvarez-Lerma, Sergio Ruiz-Santana
1Intensive Care Units of Hospital Universitario de Valme, Sevilla, Spain.
Insights
A new antiseptic hub effectively prevents catheter-related sepsis by reducing bacterial contamination. This innovation significantly lowers the incidence of catheter-related bloodstream infections in intensive care unit patients.
Area of Science:
- Infectious Diseases
- Medical Devices
- Critical Care Medicine
Background:
- Central venous catheters are essential in intensive care units but pose a risk for catheter-related sepsis.
- The catheter hub serves as a common entry point for bacteria, leading to serious infections.
Purpose of the Study:
- To evaluate the efficacy of a novel antiseptic hub (Segur-Lock) in preventing catheter contamination and bloodstream infections.
- To assess the role of an integrated antiseptic chamber in reducing bacterial entry through the catheter hub.
Main Methods:
- A prospective, randomized, multicenter study was conducted in seven Spanish intensive care units.
- 230 adult patients requiring central venous catheters for at least six days were enrolled.
- Patients received either standard Luer-lock connectors or the new antiseptic hub model.
Main Results:
- The antiseptic hub group showed a lower rate of catheter withdrawal due to suspected infection (30.1% vs. 43.8%).
- Bacterial colonization of catheter hubs was significantly reduced with the antiseptic hub (4.3% vs. 14.4%).
- Catheter-related bloodstream infections originating from the hub were less frequent in the antiseptic hub group (1.7% vs. 7%).
Conclusions:
- The Segur-Lock antiseptic hub is effective in preventing endoluminal bacterial colonization.
- This novel hub design significantly reduces catheter-related bloodstream infections associated with hub contamination in ICU patients.
Objective:
The hub connecting the catheter and the infusion equipment is a common portal of entry for bacteria causing catheter-related sepsis. We assessed the efficacy of a new hub model (Segur-Lock) that incorporates an antiseptic chamber filled with 3% iodinated alcohol in preventing endoluminal catheter contamination and catheter-related bloodstream infection arising at the hub.
Design:
Prospective, randomized, multicenter study.
Setting:
Seven medical and surgical adult intensive care units in Spain.
Patients:
A total of 230 patients aged 18 yrs or older requiring the insertion of a nontunneled central venous catheter for >or=6 days from January 1, 1998, to April 30, 1999.
Interventions:
Patients were randomized at the time of catheter insertion to receive catheters with standard Luer-lock connector (control group, n = 114) or catheters with the new hub model (n = 116).
Measurements And Main Results:
Skin, catheter tip, and hub cultures were performed at the time the catheter was withdrawn because therapy was terminated or due to suspicion of sepsis, in which case peripheral blood and infusate cultures were simultaneously taken. Catheter-related bloodstream infection was diagnosed in 19 (8.3%) patients. Catheters were more often withdrawn because of suspicion of infection in the control group (43.8%) than in the new hub model group (30.1%, p <.035). The prevalence of culture-positive catheter hubs without associated bacteremia (colonization) was higher in the control group (14.4% vs. 4.3%, p <.001). Catheter-related bloodstream infection from the catheter hub also occurred more frequently in controls than in patients assigned to the new hub model (7% vs. 1.7%; p <.049; relative risk, 4.14; 95% confidence interval, 0.8-19).
Conclusions:
This new antiseptic chamber-containing hub has proved to be effective in preventing endoluminal bacterial colonization and catheter-related bloodstream infection from hub contamination in intensive care unit patients with central venous catheters inserted for >or=6 days.
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