Efficacy of Closed Infusion System and Maximal Sterile Barrier Precautions for Reduction of Central Venous Catheter-related Blood Stream Infection

DOI Web Site 3 References
  • YOSHIMOTO Shizuo
    Infection Control Team, Kurashiki-Kojima Municipal Hospital Departments of Medicine Kurashiki-Kojima Municipal Hospital
  • YAMAITRA Mayumi
    Infection Control Team, Kurashiki-Kojima Municipal Hospital Departments of Nursing, Kurashiki-Kojima Municipal Hospital
  • OKAUCHI Satomi
    Infection Control Team, Kurashiki-Kojima Municipal Hospital Departments of Nursing, Kurashiki-Kojima Municipal Hospital
  • KANATANT Kumiko
    Infection Control Team, Kurashiki-Kojima Municipal Hospital Departments of Nursing, Kurashiki-Kojima Municipal Hospital

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  • 閉鎖式輸液回路とマキシマルバリアプレコーションの中心静脈カテーテル関連血流感染低減効果
  • ヘイサシキユエキ カイロ ト マキシマルバリアプレコーション ノ チュウシン ジョウミャク カテーテル カンレン ケツ リュウカンセン テイゲン コウカ

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Abstract

Efficacy of closed infusion system (CIS) and maximal sterile barrier precautions (MBP) for the reduction of incidence of central venous catheter (CVC)-related blood stream infection (CRBSI) was studied in CRBSI surveillance from May 2000 to March 2005 at the general ward of our hospital. The surveillance term was subdivided into three categories depending on whether CIS and/or MBP were executed or not. At the each subdivided term, infection rates of CRBSI were calculated by CVC insertion sites and durations and statistical significant difference of infection rate (SSDIR) was examined with chi-square test.<BR>Number of CVCs inserted during the surveillance was 295, of which 17 CVCs were judged to be infected according to the diagnostic criteria of CDC for BSI and total device days were 6198. Device days and infection rates (1000 device rate) of the each subdivided terms of open infusion system (OIS), CIS and CIS with MBP were 787; 6.35, 2426; 4.12 and 2985; 0.67, respectively.<BR>SSDIR between the terms with and without CIS was found in cases with CVC inserted for more than 14 days (p=0.040) but not in whole cases at the concerned terms (p=0.425). However, between the terms with and without MBP, SSDIR was found in cases with CVC for less than 14 days and whole cases at the concerned terms (p=0.024, 0.007 respectively) but not in cases with CVC for more than 14 days (p=0.244). In cases with CVC inserted at femoral site SSDIR was found between the terms with and without CIS or MBP but not in cases at subclavian site. Exactly, the differences related to CIS and MBP were found in cases with CVC for more than 14 days (p=0.020) and less than 14 days (p=0.027), respectively.<BR>These results revealed that CIS and MBP were effective to reduce infection rates of the cases with long-term CVC and short-term CVC, respectively. Consequently, for the study on efficacy of CIS and MBP for prevention of CRBSI, CVC insertion sites and durations must be considered.

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