Yohan Kwon, Dong Jae Shim, Jae Hwan Lee, Doyoung Kim, Seung Hwan Baek, Jinoo Kim, Eun Jin Kim, Youn Jeong Kim, Tae Won Choi, Je Hwan Won
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引用次数: 0
Abstract
Objectives: To investigate whether tissue adhesive (TA, 2-octyl blended with n-butyl cyanoacrylate) application to centrally/femorally inserted central catheters (CICCs/FICCs) exit sites could reduce the occurrence of central line-associated bloodstream infection (CLABSI).
Methods: This retrospective review with historical controls was conducted in three tertiary care institutions. The TA group was established from December 2021 to July 2022 with the simultaneous initiation of TA application to the exit site of CICCs/FICCs. Patients in the control group received CICCs/FICCs before TA application between February 2021 and November 2021. Adverse event (AE) rates, including CLABSI, oozing, dislocation, and skin problems, were compared between groups. Risk factors were analysed using inverse probability of treatment weighting (IPTW)-adjusted Cox analysis.
Results: The TA group comprised 1,061 patients (median age=62 years; interquartile range [IQR], 51-72; men=549), while the control group included 1,049 patients (median age=61 years; IQR, 50-72; men=516). The CLABSI rate was significantly lower in the TA group (1.84/1,000 catheter-day) compared with the control group (3.66/1,000 catheter-days), with a rate ratio of 0.5 (95% confidence interval, 0.28-0.87; p=0.01). Dislocation rates were not significantly different in the two groups (p=0.45). Pruritus and blisters at the exit-site occurred slightly more often in the TA group (TA=36, control=25, p=0.16), whereas the oozing rate was significantly lower (TA=120, control=158, p=0.01). IPTW-adjusted analysis revealed TA as risk-reducing factor (p=0.003), while age (p=0.04) and triple-lumen (p=0.04) were significant risk factors for CLABSI.
Conclusion: TA application at CICCs/FICCs exit sites could significantly lower CLABSI rates without serious AEs.
期刊介绍:
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.