Authors: Kamboj M et al., Infect Control Hosp Epidemiol 2015 Dec 36:1401
Using antiseptic barrier caps for intravenous catheter ports reduced rates of central-line–associated bloodstream infections and blood culture contamination in a high-risk cancer unit.
“Reducing to zero” the rate of central-line–associated bloodstream infections (CLABSIs) requires optimizing not only the approach to catheter insertion, but also the approach to maintaining the catheters. One recently invented approach to decrease CLABSI rates is the use of catheter-port antiseptic barrier caps that contain an antiseptic-impregnated sponge that initially disinfects the port hub during placement and thereafter physically covers the hub. Investigators have now performed a multiphase prospective trial to assess the efficacy of antiseptic barrier caps in reducing rates of CLABSIs and blood culture contamination in a single tertiary-care cancer center.
The introduction of disinfection caps was associated with a significant decrease in the hospital-wide CLABSI rate (standardized incidence ratio = 0.62). This reduction was associated with a reduction in the CLABSI rate in the three high-risk units (the intensive care unit, hematopoietic stem cell transplant unit, and leukemia-lymphoma ward) but not in the general oncology units. Use of the disinfection caps was also associated with a significant reduction in the rate of coagulase-negative staphylococcal contamination of blood cultures drawn through the catheter (SIR = 0.42). The authors estimated the annual cost of the use of the disinfection caps for this institution at approximately $202,700 and the gross cost savings from cap-related reductions in CLABSIs and contaminated blood cultures at approximately $3,472,000.
This trial is limited in being from a single institution and the use of a quasi-experimental study design. Still, the use of these devices appears to carry no apparent risk, and the cost savings in reducing the rates of CLABSIs and contaminated blood cultures could markedly outweigh the added cost of these devices in most institutions.