Effect of tissue adhesive application on central line-associated bloodstream infections: a multi-centre retrospective study.

BACKGROUND

Use of central venous access devices (CVADs) has been plagued by various adverse events, including central line-associated bloodstream infection (CLABSI), inadvertent dislocation, exit-site haemorrhage, and local infection.

AIM

To investigate whether tissue adhesive (TA, 2-octyl blended with n-butyl cyanoacrylate) application to centrally/femorally inserted central catheter (CICC/FICC) exit sites could reduce the occurrence of 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 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.

FINDINGS

The TA group comprised 1061 patients; the control group included 1049 patients. The CLABSI rate was significantly lower in the TA group (1.84 per 1000 catheter-days) compared with the control group (3.66 per 1000 catheter-days), with a rate ratio of 0.5 (95% confidence interval: 0.28-0.87; P = 0.01). 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 adverse events.