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CLABSI risk and needleless intravenous connectors meta-analysis

First published on IVTEAM 29th November 2014.

Repeat publication as full text available.

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Tabak, Y.P., Jarvis, W.R., Sun, X., Crosby, C.T. and Johannes, R.S. (2014) Meta-analysis on central line–associated bloodstream infections associated with a needleless intravenous connector with a new engineering design. American Journal of Infection Control. 42(12), p.1278–1284.


Highlights: Improved engineering design of needleless intravenous connectors that facilitate effective intravenous line care, disinfection, and management are associated with a lower risk of central line–associated bloodstream infections.

Background: Intravenous needleless connectors (NCs) with a desired patient safety design may facilitate effective intravenous line care and reduce the risk for central line–associated bloodstream infection (CLA-BSI). We conducted a meta-analysis to determine the risk for CLA-BSI associated with the use of a new NC with an improved engineering design.

Methods: We reviewed MEDLINE, Cochrane Database of Systematic Reviews, Embase,, and studies presented in 2010-2012 at infection control and infectious diseases meetings. Studies reporting the CLA-BSIs in patients using the positive-displacement NC (study NC) compared with negative- or neutral-displacement NCs were analyzed. We estimated the relative risk of CLA-BSIs with the study NC for the pooled effect using the random effects method.

Results: Seven studies met the inclusion criteria: 4 were conducted in intensive care units, 1 in a home health setting, and 2 in long-term acute care settings. In the comparator period, total central venous line (CL) days were 111,255; the CLA-BSI rate was 1.5 events per 1,000 CL days. In the study NC period, total CL days were 95,383; the CLA-BSI rate was 0.5 events per 1,000 CL days. The pooled CLA-BSI relative risk associated with the study NC was 0.37 (95% confidence interval, 0.16-0.90).

Conclusion: The NC with an improved engineering design is associated with lower CLA-BSI risk.

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