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Antiseptic chamber–containing hub reduces central venous catheter–related infection: A prospective, randomized study*

 

作者: Cristóbal León,   Francisco Álvarez-Lerma,   Sergio Ruiz-Santana,   Víctor González,   María-Victoria de la Torre,   Rafael Sierra,   Miguel León,   Juan-José Rodrigo,  

 

期刊: Critical Care Medicine  (OVID Available online 2003)
卷期: Volume 31, issue 5  

页码: 1318-1324

 

ISSN:0090-3493

 

年代: 2003

 

出版商: OVID

 

关键词: catheter-related bloodstream infection;catheter hub;cross-infection;prevention;intensive care unit;critical care;catheterization;intravenous

 

数据来源: OVID

 

摘要:

ObjectiveThe 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.DesignProspective, randomized, multicenter study.SettingSeven medical and surgical adult intensive care units in Spain.PatientsA total of 230 patients aged 18 yrs or older requiring the insertion of a nontunneled central venous catheter for ≥6 days from January 1, 1998, to April 30, 1999.InterventionsPatients 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(n = 116).Measurements and Main ResultsSkin, catheter tip, and hub cultures were performed at the time the catheter was withdrawn because therapy was terminated or due to suspicion of sepsis, in which case peripheral blood and infusate cultures were simultaneously taken.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 Catheters were more often withdrawn because of suspicion of infection in the control group (43.8%) than in the new hub model group (30.1%,p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).ConclusionsThis 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 ≥6 days.

 

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