Comparison of a Silver-Coated Needleless Connector and a Standard Needleless Connector for the Prevention of Central Line-Associated Bloodstream Infections. (30th December 2014)

• Record Type: Journal Article
• Authors: Jacob, Jesse T.; Chernetsky Tejedor, Sheri; Dent Reyes, Mary; Lu, Xin; Easley, Kirk A.; Aurand, William L.; Garrett, Gina; Graham, Kimberly; Holder, Carolyn; Robichaux, Chad; Steinberg, James P.
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 3(2015)
• Page Start: 294
• Page End: 301
• Publication Date: 2014-12-30
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2014.58
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : OBJECTIVE: To assess the impact of a novel, silver-coated needleless connectors (NCs) on central-line–associated bloodstream infection (CLABSI) rates compared with a mechanically identical NCs without a silver coating. DESIGN: Prospective longitudinal observation study SETTING: Two 500-bed university hospitals PATIENTS: All hospitalized adults from November 2009 to June 2011 with non-hemodialysis central lines INTERVENTIONS: Hospital A started with silver-coated NCs and switched to standard NCs in September 2010; hospital B started with standard NCs and switched to silver-coated NCs. The primary outcome was the difference revealed by Poisson multivariate regression in CLABSI rate using standard Centers for Disease Control and Prevention surveillance definitions. The secondary outcome was a comparison of organism-specific CLABSI rates by NC type. RESULTS: Among 15, 845 hospital admissions, 140, 186 central-line days and 221 CLABSIs were recorded during the study period. In a multivariate model, the CLABSI rate per 1, 000 central-line days was lower with silver-coated NCs than with standard NCs (1.21 vs 1.79; incidence rate ratio=0.68 [95% CI: 0.52–0.89], P =.005). A lower CLABSI rate per 1, 000 central-line days for the silver-coated NCs versus the standard NCs was observed with S. aureus (0.11 vs 0.30, P =.02), enterococci (0.10 vs 0.27, P =.03), and Gram-negative organisms (0.28 vs 0.63, P =.003) but not with coagulase-negative staphylococci (0.31 vs 0.36) or Candida spp. (0.42 vs 0.40). CONCLUSIONS: The use of silver-coated NCs decreased the CLABSI rate by 32%. CLABSI reduction efforts should include efforts to minimize contamination of NCs. Infect Control Hosp Epidemiol 2014;00(0): 1–8