Antiseptic barrier caps in central line-associated bloodstream infections: A systematic review and meta-analysis

医学 防腐剂 观察研究 荟萃分析 随机对照试验 内科学 科克伦图书馆 血流感染 子群分析 相对风险
作者
Sofía Tejada,Marta Leal-dos-Santos,Yolanda Peña-López,Stijn Blot,Emine Alp,Jordi Rello
出处
期刊:European Journal of Internal Medicine [Elsevier BV]
标识
DOI:10.1016/j.ejim.2022.01.040
摘要

Abstract

Objectives

To evaluate the evidence concerning the effectiveness of antiseptic barrier caps vs. manual disinfection in preventing central line-associated bloodstream infection (CLABSI).

Methods

The protocol of this systematic review and meta-analysis was pre-registered in PROSPERO (CRD42021259582). PubMed, Cochrane Library and Web of Science databases were searched from 2011 to 2021. Randomized-controlled trials (RCT) and observational studies on hospitalized patients of any age were included.

Results

Fourteen studies were included. Compared with manual disinfection, antiseptic barrier caps significantly reduced CLABSI rate per 1000 line-days (Standardized Mean Difference [SMD]: -0.02; 95%CI: -0.03 to -0.01) and number of CLABSI per patient (RR: 0.60; 95%CI: 0.41–0.89). Subgroup analysis showed that antiseptic barrier caps were more effective in reducing CLABSI rate per 1000 line-days in ICU (SMD: -0.02; 95%CI: -0.03 to -0.01) and non-ICU patients (SMD: -0.03; 95%CI: -0.05 to -0.01), adults (SMD: -0.02; 95%CI: -0.04 to -0.01), as in observational studies (SMD: -0.02; 95%CI: -0.02 to -0.01). Antiseptic barrier caps also significantly reduce CLABSI risk in ICU patients (RR: 0.65, 95%CI: 0.42–1.00), adults (RR: 0.50, 95%CI: 0.29–0.86), and observational studies (RR: 0.54; 95%CI: 0.32–0.91). No differences were found when only children or RCTs were taken into account. Median cost savings amongst studies were $21,890 [IQR 16,350–45,000] per CLABSI.

Conclusions

Antiseptic barrier caps appear to be effective in reducing CLABSI. The real-world impact needs to be confirmed by RCTs.
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