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Needle-free connectors catheter-related bloodstream infections: a prospective randomized controlled trial
Intensive Care Medicine Experimental Pub Date : 2019-12-01 , DOI: 10.1186/s40635-019-0277-7
Michael Koeppen 1 , Franziska Weinert 2 , Sabrina Oehlschlaeger 3 , Andreas Koerner 1 , Peter Rosenberger 1 , Helene Anna Haeberle 1
Affiliation  

BackgroundIn the critically ill, catheter-related bloodstream infection can result from bacterial contamination of infusion hubs of intravascular catheters. Needle-free connectors (NFC) have been suggested to reduce the rate of bacterial contamination and subsequent catheter-related bloodstream infection (CRBSI), but data remains ambiguous. Thus, we tested if a novel NFC would reduce bacterial contamination and subsequent CRBSI.ResultsIn a prospective, randomized controlled trial, surgical ICU patients were randomized to three-way hubs closed by caps or Bionecteur® (Vygon, Inc.) of central venous catheters. Every 72 h, infusion lines were renewed and microbiological samples were taken. Bacterial growth was analyzed by blinded microbiologists. Incidence of bacterial contamination and CRSBI were assessed. Outcome parameters like length of stay on ICU and outcome were retrospectively assessed. Two thousand seven hundred patients were screened, 111 were randomized to the NFC, and 109 into the control group. Finally, 24 patients in the NFC and 23 control patients were analyzed. The majority of samples (NFC 77%; control 70%) found no bacterial growth. Coagulase-negative staphylococci were most commonly detected on CVC samples (NFC 17%; control 21%). We found CRBSI (defined as identical pathogens in blood culture and catheter line tip culture, and clinical manifestations of infection) in two control patients and one patient of the NFC group. Their length of ICU stay did not differ between groups (NFC 19 days; control 23 days).ConclusionThe use of NFC does not influence the rate of bacterial contamination of infusion hubs of central venous catheters.Trial registrationClinicaltrials.gov, NCT02134769. Registered 09 May 2014.

中文翻译:

无针连接器导管相关血流感染:一项前瞻性随机对照试验

背景在危重病人中,导管相关的血流感染可能由血管内导管输液中心的细菌污染引起。已建议使用无针连接器 (NFC) 来降低细菌污染和随后的导管相关血流感染 (CRBSI) 的发生率,但数据仍然不明确。因此,我们测试了新型 NFC 是否会减少细菌污染和随后的 CRBSI。 结果在一项前瞻性、随机对照试验中,外科 ICU 患者被随机分配到由中心静脉导管的帽或 Bionecteur® (Vygon, Inc.) 封闭的三向枢纽. 每 72 小时更换一次输液管并采集微生物样本。细菌生长由不知情的微生物学家分析。评估了细菌污染和 CRSBI 的发生率。回顾性评估结果参数,如ICU住院时间和结果。筛选了 2700 名患者,111 名随机分配到 NFC 组,109 名进入对照组。最后,分析了 NFC 中的 24 名患者和 23 名对照患者。大多数样品(NFC 77%;对照 70%)没有发现细菌生长。凝固酶阴性葡萄球菌最常在 CVC 样本上检测到(NFC 17%;对照 21%)。我们在两名对照组患者和一名 NFC 组患者中发现了 CRBSI(定义为血培养和导管线尖端培养中的相同病原体,以及感染的临床表现)。他们的ICU住院时间在各组之间没有差异(NFC 19 天;对照组 23 天)。结论 NFC 的使用不影响中心静脉导管输液中心的细菌污染率。试验注册Clinicaltrials.gov,NCT02134769。2014 年 5 月 9 日注册。
更新日期:2019-12-01
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