Abstract
Identify the effect of the use of disinfectant port protectors on needleless connectors in the reduction of bacteraemias associated with central venous catheters. A quick review of the literature was carried out through a search of articles in English and Spanish in Pubmed, Medline, Cochrane Library and Science Direct; from December 2018 to February 2019. It focused on identifying randomized clinical trials, longitudinal cohort, systematic reviews and meta-analysis. Theinclusion criteria were: hospitalized users, passive disinfection with disinfectant port protectors and report of decrease in bacteraemias associated with central venous catheter with its use. A total of 2479 articles were identified as potentially relevant, after eliminating duplicates, 1622 articles were evaluated according to inclusion criteria were: hospitalized users, passive disinfection with disinfectant port protectors and report of decrease in bacteraemias associated with central venous catheter with its use. the available evidence suggests that non-randomized studies have shown that the use of disinfectant port protectors with 70% isopropyl alcohol in needleless connectors can lead to a reduction in bacteraemias associated with central venous catheters and could be considered as a cost measure. effective, however, randomized studies are required to confirm these results.
References
Mesiano E, Hamann E. Bloodstream infections among patients using central venous catheters in intensive care units. Rev Latino-am Enfermagem. 2007; 15(3): 453-459. DOI: http://dx.doi.org/10.1590/S0104-11692007000300014
Ramírez M. Septicemia asociada a catéter venoso central. Rev Cl EMed UCR. 2012; 2(12): 5-18. Disponible en: https://revistas.ucr.ac.cr/index.php/clinica/article/download/10426/9791/
Mandell G, Bennett J, Dolin R. Enfermedades Infecciosas, Principios y Práctica. 8va Edición. Barcelona: Elsevier; 2015.
Padrón-Ruiz OM, Ojeda N, Morales L, Rodríguez A. Infección relacionada con catéter venoso. Rev Española de Anestesiología y Reanimación. 2013; 60(4): 215-225. DOI: http://dx.doi.org/0.1016/j.redar.2012.09.007
Pages J, Hazera P, Mégarbane B, Du Cheyron D, Thuong M, Dutheil J, et al. Comparison of alcoholic chlorhexidine and povidone–iodine cutaneous antiseptics for the prevention of central venous catheter-related infection: a cohort and quasi-experimental multicenter study. Intensive Care Med. 2016; 42: 1418–1426. DOI: http://dx.doi.org/10.1007/s00134-016-4406-4
O’Grady NP, Alexander M, Burns LA, Dellinger E, Garland J, Heard S, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011; 39: 1–34. DOI: http://dx.doi.org/10.1016/j.ajic.2011.01.003
Wisplinghoff H, Bischoff T, Tallent S, Seifert H, Wenzel R, Edmond M. Nosocomial bloodstream infections in US hospitals: Analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004; 39: 309–17. DOI: http://dx.doi.org/10.1086/421946
Coello R, Charlett A, Ward V, Wilson, J. Pearson, A. Sedgwick, J. et al. Device related sources of bacteraemia in English hospitals - opportunities for the prevention of hospital-acquired bacteremia. J Hosp Infect. 2003; 53: 46–57. DOI: http://dx.doi.org/10.1053/jhin.2002.1349
Hu K, Veenstra D, Lipsky BA, Saint S. Use of maximal sterile barriers during central venous catheter insertion: clinical and economic outcomes. Clin Infect Dis. 2004; 39: 1441-1445. DOI: https://doi.org/10.1086/425309.
Allegranzi B, Bagheri S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011; 377: 228-41. DOI: https://doi.org/10.1016/S0140-6736(10)61458-4
Marschall J, Mermel LA, Classen D, Arias KM, Podgorny K, Anderson DJ, et al. Strategies to prevent central line-associated bloodstream. Infect Control Hosp Epidemiol. 2008; 29(1): 22-30. DOI: http://dx.doi.org/10.1086 / 591059
Merrill KC, Sumner S, Linford L, Taylor C, Macintosh C. Impact of universal disinfectant cap implementation on central line associated bloodstream infections. Am J Infect Control. 2014; 42: 1274-1277. DOI: http://dx.doi.org/10.1016/j.ajic.2014.09.008
Casey AL, Burnell S, Whinn H, Worthington T, Faroqui MH, Elliott TS. A prospective clinical trial to evaluate the microbial barrier of a needleless connector. Journal of Hospital Infection. 2007; 65: 212-218. DOI: http://dx.doi.org/10.1016/j.jhin.2006.09.029
Ryder MA. Catheter-related infections: it’s all about biofilm. Top Advanced Pract Nurs eJ. 2005; 5(3). Disponible en: https://www.medscape.com/viewarticle/508109
Doellman D. The role of technology in reducing risks associated with CRBSI. Ivera Medical Corporation. Disponible en: http://www.curos.com/wp-content/uploads/CRBSI-White-Paper_-DarcyDoellman.pdf
Menyhay SZ, Maki DB. Disinfection of needless catheter connectors and access ports with alcohol may not prevent microbial entry: the promise of a novel antiseptic-barrier cap. Infect Control Hosp Epidemiol. 2006; 17: 23-7. DOI: http://dx.doi.org/10.1086/500280
Oto J, Imanaka H, Konno M, Nakataki E, Nishimura M. A prospective clinical trial on prevention of catheter contamination using the hub protection cap for needleless injection device. Am J Infect Control. 2011; 39(4): 309-313. DOI: http://dx.doi.org/10.1016/j.ajic.2010.06.016
Moureau N, Flynn J. Disinfection of needleless connector hubs: clinical evidence systematic review. Nurs Res Pract. 2015; 796-762. DOI: http://dx.doi.org/10.1155/2015/796762
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009; 6(7): e1000097. DOI: https://doi.org/10.1371/journal.pmed.1000097
Joanna Briggs Institute. Critical Appraisal tools for use in JBI Systematic Reviews. Checklist for Systematic Reviews and Research Syntheses. 2017. Disponible en: http://joannabriggs.org/research/critical-appraisal-tools.html
Voor in t holt A, Helder O, Vos M, Schafthuizen L, Sülz S, Van den Hoogen, et al. Antiseptic barrier cap effective in reducing central line-associated bloodstream infections: A systematic review and meta-analysis. Int J Nurs Stud. 2017; 69: 34-40. DOI: http://dx.doi.org/10.1016/j.ijnurstu.2017.01.007
Flynn J, Larsen E, Keogh S, Ullman A, Rickard C. Methods for microbial needleless connector decontamination: A systematic review and meta-analysis. Am J Infect Control. 2019; 000: 1-7. DOI: http://doi.org/10.1016/j.ajic.2019.01.002

