Antiseptic barrier caps to prevent central line-associated bloodstream infections: A systematic review and meta-analysis - 20/06/23
, Marijn J. van Es, MSc, Yannick Wouters, MD, PhD, Geert J.A. Wanten, MD, PhDGraphical abstract |
Highlights |
• | A safe and reliable central venous access is the cornerstone of treatments in numerous clinical settings. |
• | Antiseptic barrier caps seems an effective strategy to reduce central line-associated bloodstream infections (CLABSI). |
• | Antiseptic barrier caps are safe, time-saving, and highly appreciated by health care workers for their ease of use. |
• | Monitoring of Antiseptic barrier caps (ABC) use, and availability of caps is key to improving and maintaining compliance. |
Résumé |
Background |
Reliable and safe venous access is crucial for patients using central venous catheters (CVC). However, such CVCs carry a risk for central line-associated bloodstream infections (CLABSIs). Antiseptic barrier caps (ABCs) are a novel tool in the armamentarium for CVC disinfection. Our aim was to review the efficacy and safety of ABCs.
Method |
A literature search was conducted using MedLine, EMBASE, Cochrane library, and CINAHL. Primary aim was to compare CLABSI rates in patients using ABCs versus standard care. Secondary aims included efficacy of ABCs in relevant subgroups (age, ABC brand, clinical setting), safety, compliance, and costs. Fifteen studies were included in the meta-analysis.
Results |
In total, 391 CLABSIs in 273,993 catheter days occurred in the intervention group versus 620 CLABSIs in 284,912 days in the standard care group, resulting in a risk ratio of 0.65 (95%CI 0.55-0.76; P < .00001). Subgroup analyses showed similar effects, except for nonintensive care unit. In general, ABCs were safe, highly appreciated by patients and caregivers, and cost-effective, while compliance was easy to monitor. In most studies, a substantial risk of bias was observed.
Conclusion |
In conclusion, while available evidence suggests that ABCs are effective, safe, easy in use, and cost-effective. However, due to the poor methodological quality of most available studies, more robust data should justify their use at this point.
Le texte complet de cet article est disponible en PDF.Key Words : Catheter-related bloodstream infection, Central venous catheter, Infection control, Passive disinfection
Plan
| Conflicts of interest: G.W. reports grants from Geistlich Pharma, and consulting fees from Geistlich Pharma and Zealand outside the submitted work. All other authors declare that they have no conflict of interest. |
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| Author contributions: V.G. Conceptualization, methodology, validation, formal analysis, investigation, data curation, writing - original draft, writing - review and editing, visualization, project administration. MvE: Conceptualization, methodology, validation, investigation, data curation, writing - original draft, writing – review, and editing. Y.W. Conceptualization, methodology, validation, writing – review, and editing. G.W. Conceptualization, methodology, validation, writing - review and editing, supervision. |
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| Data sharing: Data described in the manuscript, code book, and analytic code will be made available upon request pending approval |
Vol 51 - N° 7
P. 827-835 - juillet 2023 Retour au numéro
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