Major Article| Volume 48, ISSUE 3, P281-284, March 2020

Impact of needle-free connectors compared with 3-way stopcocks on catheter-related bloodstream infection rates: A meta-analysis

  • Victor Daniel Rosenthal
    Address correspondence to Victor Daniel Rosenthal, MD, International Nosocomial Infection Control Consortium, 11 de Septiembre 4567, Floor 12, Apt 1201, Buenos Aires 1429, Argentina.
    International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
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Published:September 21, 2019DOI:


      • This meta-analysis compared catheter-related bloodstream infection rates in needle-free connectors vs. three-way stopcocks.
      • Cochrane and MEDLINE were searched for randomized studies published from 01/01/2000 to 09/01/2018.
      • Catheter-related bloodstream infection risk was statistically higher with three-way stopcocks than with needle-free connectors.


      Needle-free connectors (NFCs) were introduced to eliminate the use of needles in intravascular catheters, and their newest generations were designed to improve patient safety and reduce catheter-related bloodstream infection (CRBSI) risks. The aim of this meta-analysis was to compare NFCs with 3-way stopcocks (3WSCs) and their effects on CRBSI rates.


      A meta-analysis was conducted using a research protocol consistent with the PRISMA statement for reporting meta-analyses. The Cochrane Database of Systematic Reviews and MEDLINE were searched for relevant randomized studies published from January 2000 to September 2018.


      We identified and selected for the meta-analysis 8 studies comparing CRBSI rates (according to the Centers for Disease Control and Prevention's National Healthcare Safety Network definition) associated with NFCs utilizing negative-displacement, neutral-displacement, or positive-displacement devices with rates for 3WSCs. Relative risk was 0.53 with a 95% CI of 0.28 to 1.00, and the relative difference was –0.018 with a 95% CI of –0.039 to 0.004.


      CRBSI risk was statistically higher for 3WSCs compared to NFCs.

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          In the article “Impact of needle-free connectors compared with 3-way stopcocks on catheter-related bloodstream infection rates: A meta-analysis.” by Victor D. Rosenthal. in the March issue of the American Journal of Infection Control (2020;48(3):281-84.
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