CLABSI reduction using tissue adhesive
Abstract:
Objectives: To investigate whether tissue adhesive (TA, 2-octyl blended with n-butyl cyanoacrylate) application to centrally/femorally inserted central catheters (CICCs/FICCs) exit sites could reduce the occurrence of central line-associated bloodstream infection (CLABSI).
Methods: This retrospective review with historical controls was conducted in three tertiary care institutions. The TA group was established from December 2021 to July 2022 with the simultaneous initiation of TA application to the exit site of CICCs/FICCs. Patients in the control group received CICCs/FICCs before TA application between February 2021 and November 2021. Adverse event (AE) rates, including CLABSI, oozing, dislocation, and skin problems, were compared between groups. Risk factors were analysed using inverse probability of treatment weighting (IPTW)-adjusted Cox analysis.
Results: The TA group comprised 1,061 patients (median age=62 years; interquartile range [IQR], 51-72; men=549), while the control group included 1,049 patients (median age=61 years; IQR, 50-72; men=516). The CLABSI rate was significantly lower in the TA group (1.84/1,000 catheter-day) compared with the control group (3.66/1,000 catheter-days), with a rate ratio of 0.5 (95% confidence interval, 0.28-0.87; p=0.01). Dislocation rates were not significantly different in the two groups (p=0.45). Pruritus and blisters at the exit-site occurred slightly more often in the TA group (TA=36, control=25, p=0.16), whereas the oozing rate was significantly lower (TA=120, control=158, p=0.01). IPTW-adjusted analysis revealed TA as risk-reducing factor (p=0.003), while age (p=0.04) and triple-lumen (p=0.04) were significant risk factors for CLABSI.
Conclusion: TA application at CICCs/FICCs exit sites could significantly lower CLABSI rates without serious AEs.
Reference:
Kwon Y, Shim DJ, Lee JH, Kim D, Baek SH, Kim J, Kim EJ, Kim YJ, Choi TW, Won JH. Effect of tissue adhesive application on central line-associated bloodstream infections: A multi-centre retrospective study. J Hosp Infect. 2025 May 10:S0195-6701(25)00133-1. doi: 10.1016/j.jhin.2025.04.030. Epub ahead of print. PMID: 40355087.