Yébenes J C, Sauca G, Solsona M, Martinez R, Serra-Prat M, Gil P, Riera F, Balanzó X
Intensive Care Unit, Hospital de Mataró, Barcelona, Spain.
J Hosp Infect. 2008 Dec;70(4):341-5. doi: 10.1016/j.jhin.2008.08.016. Epub 2008 Oct 31.
Needleless valve connectors were introduced to avoid needlestick injuries in healthcare workers but some concerns exist about their microbiological safety. A randomised controlled trial was performed to assess hub colonisation affecting positive-pressure valve connectors (PPVCs) compared to conventional caps used for radial arterial catheters inserted into critically ill patients. Patients were randomly assigned either to the PPVC (Smartsite Plus positive bolus valve) or to the conventional cap group. Only catheters inserted for >24h were analysed. Of 100 consecutive arterial lines, 80 were inserted for >24h (mean insertion duration 5.8 days), 41 in the PPVC group and 39 in the conventional cap group. Catheter hubs were colonised in eight cases in the control group (20.5%) and in one case in the PPVC group (2.4%). Hub colonisation was caused by coagulase-negative staphylococci in all cases. No attributable bacteraemia was observed. In multivariate analysis, PPVC (odds ratio: 0.09; 95% confidence interval: 0.1-0.79; P=0.03) and use of the line for continuous haemodynamic monitoring (0.16; 0.03-0.89; P=0.037) were independently associated with a lower incidence of hub colonisation.
无针阀连接器被引入以避免医护人员发生针刺伤，但对其微生物安全性存在一些担忧。进行了一项随机对照试验，以评估与用于插入重症患者桡动脉导管的传统帽相比，影响正压阀连接器（PPVC）的接头定植情况。患者被随机分配到PPVC组（Smartsite Plus正推注阀）或传统帽组。仅分析插入时间超过24小时的导管。在连续的100条动脉导管中，80条插入时间超过24小时（平均插入持续时间5.8天），PPVC组41条，传统帽组39条。对照组有8例（20.5%）导管接头定植，PPVC组有1例（2.4%）。所有病例的接头定植均由凝固酶阴性葡萄球菌引起。未观察到可归因的菌血症。在多变量分析中，PPVC（比值比：0.09；95%置信区间：0.1 - 0.79；P = 0.03）和使用该导管进行连续血流动力学监测（0.16；0.03 - 0.89；P = 0.037）与接头定植发生率较低独立相关。
