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

Article

Flynn, Julie M., Larsen, Emily N., Keogh, Samantha, 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. https://doi.org/10.1016/j.ajic.2019.01.002
Article Title

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

ERA Journal ID15641
Article CategoryArticle
AuthorsFlynn, Julie M. (Author), Larsen, Emily N. (Author), Keogh, Samantha (Author), Ullman, Amanda J. (Author) and Rickard, Claire M. (Author)
Journal TitleAmerican Journal of Infection Control
Journal Citation47 (8), pp. 956-962
Number of Pages7
Year2019
Place of PublicationUnited States
ISSN0161-6005
0196-6553
1527-3296
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ajic.2019.01.002
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S0196655319300069
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.

KeywordsBloodstream infection; CABSI; CLABSI; Vascular access device
Related Output
Is reviewed byResponse to the Letter to the Editor regarding “Methods for microbial needleless connector decontamination: A systematic review and meta-analysis”
ANZSRC Field of Research 2020420506. Sub-acute care
420501. Acute care
420599. Nursing not elsewhere classified
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Byline AffiliationsGriffith University
Department of Health, Queensland
Institution of OriginUniversity of Southern Queensland
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