Author:
Salgado Cassandra D.,Chinnes Libby,Paczesny Tammy H.,Cantey J. Robert
Abstract
Objective.To determine whether introduction of a needleless mechanical valve device (NMVD) at a long-term acute care hospital was associated with an increased frequency of catheter-related bloodstream infection (BSI).Design.For patients with a central venous catheter in place, the catheter-related BSI rate during the 24-month period before introduction of the NMVD, a period in which a needleless split-septum device (NSSD) was being used (hereafter, the NSSD period), was compared with the catheter-related BSI rate during the 24-month period after introduction of the NMVD (hereafter, the NMVD period). The microbiological characteristics of catheter-related BSIs during each period were also compared. Comparisons and calculations of relative risks (RRs) with 95% confidence intervals (CIs) were performed using χ2 analysis.Results.Eighty-six catheter-related BSIs (3.86 infections per 1,000 catheter-days) occurred during the study period. The rate of catheter-related BSI during the NMVD period was significantly higher than that during the NSSD period (5.95 vs 1.79 infections per 1,000 catheter-days; RR, 3.32 [95% CI, 2.88–3.83]; P < .001). A significantly greater percentage of catheter-related BSIs during the NMVD period were caused by gram-negative organisms, compared with the percentage recorded during the NSSD period (39.5% vs 8%; P = .007). Among catheter-related BSIs due to gram-positive organisms, the percentage caused by enterococci was significantly greater during the NMVD period, compared with the NSSD period (54.8% vs 13.6%; P = .004). The catheter-related BSI rate remained high during the NMVD period despite several educational sessions regarding proper use of the NMVD.Conclusions.An increased catheter-related BSI rate was temporally associated with use of a NMVD at the study hospital, despite several educational sessions regarding proper NMVD use. The current design of the NMVD may be unsafe for use in certain patient populations.
Publisher
Cambridge University Press (CUP)
Subject
Infectious Diseases,Microbiology (medical),Epidemiology
Reference24 articles.
1. Rates of Needle-Stick Injury Caused by Various Devices in a University Hospital
2. Hall KK , Geffers C , Giannetta E , Farr BM . Outbreak of bloodstream infections temporally associated with a new needleless IV infusion system. In: Program and abstracts of the 14th Annual Scientific Meeting of the Society for Healthcare Epidemiologists of America; April 17-20, 2004; Philadelphia. Abstract 285.
3. Efficacy and cost-effectiveness of a needleless intravenous access system
4. Occupational Exposures to Body Fluids among Medical Students: A Seven-Year Longitudinal Study
Cited by
82 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献