Abstract | BACKGROUND: Hospitalized patients in critical care settings are at risk for bloodstream infections (BSI). Most BSIs originate from a central line (CL), and they increase length of stay, cost, and mortality. Open infusion containers may increase the risk of contamination and administration-related (CLAB) because they allow the entry of air into the system, thereby also providing an opportunity for microbial entry. Closed infusion containers were designed to overcome this flaw. However, open infusion containers are still widely used throughout the world.The objective of the study was to determine the effect of switching from open (glass, burettes, and semi-rigid) infusion containers to closed, fully collapsible, plastic infusion containers ( Viaflex) on the rate and time to onset of central line-associated bloodstream infections CLABs. METHODS: RESULTS: A total of 1,096 adult patients who had a central line in place for >24 hours were enrolled. The CLAB rate was significantly higher during the open versus the closed container period (16.1 versus 3.2 CLAB/1000 central line days; RR = 0.20, 95% CI = 0.11-0.36, P < 0.0001). The probability of developing CLAB remained relatively constant in the closed container period (1.4% Days 2-4 to 0.5% Days 8-10), but increased in the open container period (4.9% Days 2-4 to 5.4% Days 8-10). The chance of acquiring a CLAB was significantly decreased (81%) in the closed container period (Cox proportional hazard ratio 0.19, P < 0.0001). Mortality was statistically significantly lower during the closed versus the open container period (23.4% versus 16.1%; RR = 0.69, 95% CI = 0.54-0.88, P < 0.01). CONCLUSIONS: Closed infusion containers significantly reduced CLAB rate, the probability of acquiring CLAB, and mortality.
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Authors | Manuel S Rangel-Frausto, Francisco Higuera-Ramirez, Jose Martinez-Soto, Victor D Rosenthal |
Journal | Annals of clinical microbiology and antimicrobials
(Ann Clin Microbiol Antimicrob)
Vol. 9
Pg. 6
(Feb 02 2010)
ISSN: 1476-0711 [Electronic] England |
PMID | 20122280
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Bacteremia
(etiology, prevention & control)
- Cohort Studies
- Drug Packaging
- Humans
- Intensive Care Units
- Mexico
- Prospective Studies
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