Methods for microbial needleless connector decontamination: A systematic review and meta-analysis

Flynn, Julie M. ORCID: https://orcid.org/0000-0003-1512-2089 and Larsen, Emily N. and Keogh, Samantha and Ullman, Amanda J. and Rickard, Claire M. (2019) Methods for microbial needleless connector decontamination: A systematic review and meta-analysis. American Journal of Infection Control, 47 (8). pp. 956-962. ISSN 0196-6553


Abstract

Background: The objective of this review was to compare the effectiveness of connector decontamination with 70% alcohol wipes, alcoholic chlorhexidine gluconate wipes, or alcohol impregnated caps to prevent catheter-associated bloodstream infection (CABSI). Methods: A systematic search was conducted in CINAHL, Cochrane Central Register of Controlled Trials, Medline, and PubMed. The primary outcome was CABSI, with randomized and observational studies included. The inclusion criteria were: English language, any age group, no date limitations, and reporting connector decontamination interventions to prevent CABSI. The exclusion criteria were: multimodal interventions, letters, and conference abstracts. Quality assessment with the Newcastle-Ottawa Scale, a narrative synthesis, and meta-analysis were conducted. Pooled data used a random effects model for pair-wise comparisons, due to clinical heterogeneity. Statistical heterogeneity was investigated by visual model inspection, χ², and I² statistics. Results: Ten studies compared 70% alcohol wipes with 70% alcohol-impregnated caps, and 2 studies (n = 1,216) tested an alcoholic chlorhexidine gluconate wipe. Alcoholic chlorhexidine gluconate wipes were associated with significantly less CABSI than 70% alcohol wipes (risk ratio, 0.28; 95% confidence interval, 0.20-0.39). Alcohol-impregnated caps were associated with significantly less CABSI than 70% alcohol wipes (risk ratio, 0.43; 95% confidence interval, 0.28-0.65). Studies were of low to moderate quality. Conclusions: Alcohol impregnated caps and alcoholic chlorhexidine gluconate wipes were associated with significantly less CABSI than 70% alcohol wipes. This requires confirmation in randomized controlled trials.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Response to article in https://eprints.usq.edu.au/44699/
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 10 Dec 2021 01:03
Last Modified: 16 Dec 2021 03:20
Uncontrolled Keywords: Bloodstream infection; CABSI; CLABSI; Vascular access device
Fields of Research (2008): 11 Medical and Health Sciences > 1110 Nursing > 111003 Clinical Nursing: Secondary (Acute Care)
11 Medical and Health Sciences > 1110 Nursing > 111099 Nursing not elsewhere classified
Fields of Research (2020): 42 HEALTH SCIENCES > 4205 Nursing > 420506 Sub-acute care
42 HEALTH SCIENCES > 4205 Nursing > 420501 Acute care
42 HEALTH SCIENCES > 4205 Nursing > 420599 Nursing not elsewhere classified
Identification Number or DOI: https://doi.org/10.1016/j.ajic.2019.01.002
URI: http://eprints.usq.edu.au/id/eprint/44662

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