Impact of needle-free connectors compared with 3-way stopcocks on catheter-related bloodstream infection rates: A meta-analysis

• Published in: American journal of infection control Vol. 48; no. 3; pp. 281 - 284
• Main Author: Rosenthal, Victor Daniel
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2020
• Subjects: Bacteremia - etiology; Bacteremia - microbiology; Catheter-Related Infections - etiology; Catheter-Related Infections - microbiology; Catheterization, Central Venous - adverse effects; Central Venous Catheters - microbiology; Cross Infection - etiology; Cross Infection - microbiology; Disinfection - methods; Humans; Mechanical valve; Needleless connector; Needles - microbiology; Negative-, positive-, and neutral-displacement needleless connectors; Observational Studies as Topic; Open system connectors; Prospective Studies; Randomized Controlled Trials as Topic; Sepsis - etiology; Sepsis - microbiology; Split septum; Split septum; Mechanical valve; Needleless connector; Open system connectors; Negative-, positive-, and neutral-displacement needleless connectors
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2019.08.015

•This meta-analysis compared catheter-related bloodstream infection rates in needle-free connectors vs. three-way stopcocks.•Cochrane and MEDLINE were searched for randomized studies published from 01/01/2000 to 09/01/2018.•Catheter-related bloodstream infection risk was statistically higher with three-way stopcocks than with needle-free connectors. Needle-free connectors (NFCs) were introduced to eliminate the use of needles in intravascular catheters, and their newest generations were designed to improve patient safety and reduce catheter-related bloodstream infection (CRBSI) risks. The aim of this meta-analysis was to compare NFCs with 3-way stopcocks (3WSCs) and their effects on CRBSI rates. A meta-analysis was conducted using a research protocol consistent with the PRISMA statement for reporting meta-analyses. The Cochrane Database of Systematic Reviews and MEDLINE were searched for relevant randomized studies published from January 2000 to September 2018. We identified and selected for the meta-analysis 8 studies comparing CRBSI rates (according to the Centers for Disease Control and Prevention's National Healthcare Safety Network definition) associated with NFCs utilizing negative-displacement, neutral-displacement, or positive-displacement devices with rates for 3WSCs. Relative risk was 0.53 with a 95% CI of 0.28 to 1.00, and the relative difference was –0.018 with a 95% CI of –0.039 to 0.004. CRBSI risk was statistically higher for 3WSCs compared to NFCs.