Impact of Alcohol Impregnated Protectors on Incidence of Catheter- Associated Blood Stream Infections
Faisal Alasmari1, Nupur D. Kittur1, Anthony J Russo2, Kathleen M. McMullen2, Kathleen Rensing2, Erik R. Dubberke1, Jennie L. Mayfield 2
1 Washington University School of Medicine, 2 Barnes-Jewish Hospital,St.Louis, MO,
Background: Central venous catheters (CVC) are an essential component of managing patients with hematologic malignancies. However, catheters can serve as a nidus for infection. We conducted a before-after study with a non-equivalent control to determine the efficacy of Curos® alcohol impregnated port protectors to decrease catheter-associated bloodstream infections (CABSI) on a hematologic malignancy ward.
Methods: This study was conducted at Barnes-Jewish Hospital from Jan 1, 2010, to Dec 31, 2011. The intervention was use of alcohol impregnated catheter port protectors placed on all CVC ports. The intervention ward primarily cares for patients with acute leukemia and readmissions after stem cell transplantation (SCT). The control ward primarily cares for patient undergoing SCT. Rates of National Healthcare Safety Network (NHSN) defined CABSI per 1000 central line days were measured at monthly intervals. Segmented regression analysis of interrupted time series was used to determine the impact of the intervention on CABSI rates.
Intervention Ward: There were 22,662 line days (11,213 pre-, 11,449 post-intervention). The monthly median CABSI rate was 5.3 (range: 3.1 - 7.2) pre- and 3.7 (range: 1.0 - 7.2) post- intervention period. The pre-intervention CABSI rate linear trend was 0.21(95% CI: 0.05, 0.37) and the post-intervention trend was - 0.19(95%CI:-0.35,-.02). Segmented regression did not demonstrate a statistically significant change in CABSI rate post-intervention.
Control Ward: There were 17,670 line days (8,913 pre-and 8,757 post-intervention period). The monthly median CABSI rate was 5.6 (range: 2.6 - 10.3) pre-intervention and 5.4 (range: 2.7 - 11.3) post-intervention. The pre-intervention CABSI rate linear trend was 0.06 (95% CI: - 0.19, 0.32) and the post-intervention trend was - 0.04 (95%CI:-0.29, 0.22).
Conclusion: The greater rate of decline in CABSI on the intervention ward versus the control ward, while not statistically significant, may indicate a clinically significant change in CABSI trends on the intervention ward.
N. D. Kittur, None
A. J. Russo, None
K. McMullen, None
K. Rensing, None
E. Dubberke, Optimer: Consultant, Grant Investigator and Speaker's Bureau, Consulting fee, Research support and Speaker honorarium
Pfizer: Consultant, Consulting fee
Merck: Consultant and Investigator, Consulting fee and Research support
Sanofi Pasteur: Consultant, Consulting fee
Viropharma: Investigator, Research support