AJIC: American Journal of Infection Control
Volume 36, Issue 10 , Pages S175.e1-S175.e4 , December 2008

Clinical use of disinfectable needle-free connectors

  • Juan C. Yébenes, MD, PhD

      Affiliations

    • Intensive Care Unit, Hospital de Mataró, Barcelona, Spain
    • Corresponding Author InformationAddress correspondence to Juan C. Yébenes, MD, PhD, Hospital de Mataró, Intensive Care Unit, 08304 Mataro, Barcelona, Spain.
  • ,
  • Mateu Serra-Prat, MD, PhD, MPH

      Affiliations

    • Research Unit, Hospital de Mataró, Barcelona, Spain

References 

  1. Vallés J, León C, Alvarez-Lerma F. Nosocomial bacteremia in critically ill patients: a multicenter sudy evaluating epidemiology and prognosis. Clin Infect Dis. 1997;24:387–395
  2. Mermel LA. Defining intravascular catheter-related infections: a plea for uniformity. Nutrition. 1997;13(Suppl 4):S2–S4
  3. Wenzel RP, Edmond MB. Team-based prevention of catheter-related infections. N Engl J Med. 2006;355:2781–2783
  4. National Nosocomial Infections Surveillance System . National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32:470–485
  5. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006;81:1159–1171
  6. Rello J, Ochogavia A, Sabanes E, Roque M, Mariscal D, Reynaga E, et al. Evaluation of outcome of intravenous catheter-related infections in critically ill patients. Am J Respir Crit Care. 2000;162:1027–1030
  7. Renaud B, Brun-Buisson C for the ICU-Bacteremia Study Group. Outcomes of primary and catheter-related bacteremia: a cohort and case-control study in critically ill patients. Am J Respir Crit Care Med. 2001;163:1584–1590
  8. DiGiovine B, Chenoweth C, Watts C, Higgins M. The attributable mortality and costs of primary nosocomials bloodstream infections in the intensive care unit. Am J Respir Crit Care Med. 1999;160:976–981
  9. Sitges-Serra A, Liñares J, Garau J. Catheter sepsis: the clue is the hub. Surg. 1985;97:355–357
  10. Raad I, Costerton JW, Sabharwal U, Sacilowski M, Anaissie E, Bodey GP. Ultrastructural analysis of indwelling catheters: a quantitative relationship between luminal colonization and duration of placement. J Infect Dis. 1993;168:400–407
  11. Atela I, Coll P, Rello J, Quintana E, Barrio J, March F, et al. Serial surveillance cultures of skin and catheter hub specimens from critically ill patients with central venous catheters: molecular epidemiology of infection and implications for clinical management and research. J Clin Microbiol. 1997;35:1784–1790
  12. O'Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2002;51(RR-10):1–29
  13. Benson JS. Needlestick and other risk from hypodermic needles on secondary IV, administrations sets, piggyback and intermittent IV. FDA Bulletin, Appendix A, FDA Safety Alert; April 16, 1992.
  14. Lawrence LW, Delclos GL, Felknor SA, Johnson PC, Frankowski RF, Cooper SP, et al. The effectiveness of a needle-free intravenous connection system: an assessment by injury rate and user satisfaction. Infect Control Hosp Epidemiol. 1997;18:175–182
  15. Cookson ST, Ihrig M, O'Mara EM, Denny M, Volk H, Banerjee SN, et al. Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol. 1998;19:23–27
  16. Menyhay SZ, Maky DG. Disinfection of needleless catheter connectors and access ports with alcohol may not prevent microbial entry: the promise of a novel antiseptic-barrier cap. Infect Control Hosp Epidemiol. 2006;27:23–27
  17. Luebcke MA, Arduino MJ, Duda DL, Dudar TE, McAllister SK, Bland LA, et al. Comparison of the microbial barrier properties of a needleless and a conventional needle-based intravenous access system. Am J Infect Control. 1998;26:437–441
  18. Yebenes JC, Martnez R, Serra-Prat M, Sauca G, Capdevila JA, Blanco X, et al. Resistance to the migration of microorganisms of a needle-free disinfectable connector. Am J Infect Control. 2003;31:462–464
  19. Yébenes JC, Delgado M, Sauca G, Serra-Prat M, Solsona M, Almirall J, et al. Efficacy of 3 different valve systems of needle-free closed connectors in avoiding access of microorganisms to endovascular catheters after incorrect handling. Crit Care Med. 2008;36:2558–2561
  20. Bouza E, Munoz P, Lopez-Rodriguez J, Perez MJ, Rincón C, Martin Rabandán P, et al. A needleless closed system device (CLAVE) protects from intravascular catheter tip and hub colonization: a prospective randomized study. J Hosp Infect. 2003;54:279–287
  21. Yebenes JC, Vidaur L, Serra-Prat M, Sirvent JM, Batlle J, Motje M, et al. Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: a randomized controlled trial. Am J Infect Control. 2004;32:291–295
  22. Esteve F, Pujol M, Limón E, Saballs M, Argerich MJ, Verdaguer R, et al. Bloodstream infection related to catheter connections: a prospective trial of two connection systems. J Hosp Infect. 2007;67:30–34
  23. Yébenes JC, Sauca G, Solsona M, Martínez R, Serra-Part M, Gil P, et al. Safety of positive-pressure valve connectors in aterial catheters inserted into critically ill patients. J Hosp Infect. 2008;70:341–345
  24. Salgado C, Chinnes L, Paczesny T, Cantey JR. Increased rate of catheter-related bloodstream infection associated with the use of a needleless mechanical valve device at a long-term acute care hospital. Infect Control Hosp Epidemiol. 2007;28:684–688
  25. Field K, McFarlane C, Cheng A, Hughes A, Jacobs E, Styles K, et al. Incidence of catheter-related bloodstream infection among patients with a needleless mechanical valve based intravenous connection in an Australian hematology-oncology unit. Infect Control Hosp Epidemiol. 2007;28:610–613
  26. Rupp M, Sholtz L, Jourdan D, Marion ND, Tyner LK, Fey PD, et al. Outbreak of bloodstream infection temporally associated with the use of an intravascular needleless valve. Clin Infect Dis. 2007;44:1408–1414
  27. Maragakis LL, Kl Bradley, Song X, Beers C, Miller MR, Cosgrove SE, et al. Increased catheter-related bloodstream infection rates after the introduction of a new mechanical valve intravenous access port. Infect Control Hosp Epidemiol. 2006;27:67–70
  28. Schilling S, Doellman D, Hutchinson N, Jacobs B. The impact of needleless connector device design on central venous catheter occlusion in children: a prospective, controlled trial. J Parenter Enteral Nutr. 2006;30:85–90
  29. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006;355:2725–2732
  30. Delgado M, Yébenes JC, Zaro T, Pérez Massip M, Lavado E, Cegarra M, et al. Use of disinfectable needleless mechanical valve connectors and catheter-related bloodstream infection rates in a polyvalent intensive care unit. Clin Microbiol Infect. 2008;S7:S296

 Disclosures: Dr. Yébenes received an honorarium for participating in the symposium and writing this article. Dr. Yébenes has received grants to develop an educational program in his hospital from Cardinal Health. Dr. Serra-Prat reports no conflicts of interest.

PII: S0196-6553(08)00798-0

doi: 10.1016/j.ajic.2008.10.013

AJIC: American Journal of Infection Control
Volume 36, Issue 10 , Pages S175.e1-S175.e4 , December 2008