Introduction Catheter related sepsis (CRS) can result in disrupted feeding, parenteral nutrition (PN) waste, systemic sepsis, central vein thrombosis and potential prolonged hospital stay in inpatients receiving PN. Alcohol-impregnated disinfection caps reduce CRS in home PN patients1and hospital inpatients with indwelling central lines.2Their role in reduction of CRS in inpatients receiving PN is less clear.
Method Prospective data from inpatients receiving PN from April 2013 to January 2015 was assessed. CUROSTMline caps were introduced on 8/09/14 in addition to an existing standard aseptic non-touch technique for all patients receiving PN. Patients received PN via a peripherally inserted central catheter or a dedicated port of a central venous catheter. CRS were analysed in patients without and with the CUROSTMdevice and expressed as events/1000 catheter days. CRS was confirmed by a positive culture from blood withdrawn from the line or from line tip culture.
Results There were no differences in baseline characteristics between the 2 groups (Table 1).
In the 17 months prior to the caps being used the incidence of line infections in patients receiving PN was 6.17/1000 line days. In the 5 months after their introduction this fell to 0.00/1000 line days (p-value 0.014)
Conclusion Upon introduction of a simple alcohol-impregnated disinfection cap there has been a significant fall in CRS rates related to PN. The cost to the Trust of a CUROSTMcap is £0.32 and further assessment of the cost saving to the Trust will be undertaken.
Disclosure of interest None Declared.
Small M. The impact of 70% isopropyl alcohol port protection caps on catheter related bloodstream infection in patients on home parenteral nutrition. Poster, World Congress Vascular Access 2014
Merrill KC, Sumner S, Linford L, et al. Impact of universal disinfectant cap implementation on central line-associated bloodstream infections. American Journal of Infection Control 2014;42:1274–7
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