Major article
Meta-analysis on central line–associated bloodstream infections associated with a needleless intravenous connector with a new engineering design,

Previous presentation: An abstract based on part of the analytical results has been accepted for presentation at IDWEEK 2014; October 10, 2014; Philadelphia, PA.
https://doi.org/10.1016/j.ajic.2014.08.018Get rights and content
Under a Creative Commons license
open access

Highlights

  • Improved engineering design of needleless intravenous connectors that facilitate effective intravenous line care, disinfection, and management are associated with a lower risk of central line–associated bloodstream infections.

Background

Intravenous needleless connectors (NCs) with a desired patient safety design may facilitate effective intravenous line care and reduce the risk for central line–associated bloodstream infection (CLA-BSI). We conducted a meta-analysis to determine the risk for CLA-BSI associated with the use of a new NC with an improved engineering design.

Methods

We reviewed MEDLINE, Cochrane Database of Systematic Reviews, Embase, ClinicalTrials.gov, and studies presented in 2010-2012 at infection control and infectious diseases meetings. Studies reporting the CLA-BSIs in patients using the positive-displacement NC (study NC) compared with negative- or neutral-displacement NCs were analyzed. We estimated the relative risk of CLA-BSIs with the study NC for the pooled effect using the random effects method.

Results

Seven studies met the inclusion criteria: 4 were conducted in intensive care units, 1 in a home health setting, and 2 in long-term acute care settings. In the comparator period, total central venous line (CL) days were 111,255; the CLA-BSI rate was 1.5 events per 1,000 CL days. In the study NC period, total CL days were 95,383; the CLA-BSI rate was 0.5 events per 1,000 CL days. The pooled CLA-BSI relative risk associated with the study NC was 0.37 (95% confidence interval, 0.16-0.90).

Conclusion

The NC with an improved engineering design is associated with lower CLA-BSI risk.

Key Words

Meta-analysis
Bloodstream infection
Central line–associated bloodstream infection
Needleless connector
Positive-displacement valve

Cited by (0)

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

Conflicts of interest: There was no specific grant for this study. Authors of this meta-analysis include employees of CareFusion and a clinical expert who provides consulting services to Baxter, CareFusion, Gojo, and Johnson and Johnson. He served as an unpaid clinical consultant and a coauthor for this article.

Additional information: None of these authors of the studies included in the meta-analysis were (or are) CareFusion employees or received financial support from CareFusion, the manufacturer of the study NC device. None of the studies in the meta-analysis were funded by CareFusion.