Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A...

Autores
Rosenthal, Victor Daniel; Udwadia, Farokh Earch; Kumar, Siva; Poojary, Aruna; Sankar, Rathi; Orellano, Pablo Wenceslao; Durgad, Shilpa; Thulasiraman, Mahendran; Bahirune, Shweta; Kumbhar, Shubhangi; Patil, Priyanka
Año de publicación
2015
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background Three-way stopcocks (3WSCs) are open systems used on intravenous tubing. Split septums (SSs) are closed systems with prepierced septums. Single-use prefilled flushing devices (SUFs) carry a lower risk of contamination than standard intravenous flushing. 3WSC and standard flushing are widely used in developing countries. This is the first randomized clinical trial (RCT) to compare rates of central line-associated bloodstream infection (CLABSI) between patients using an SS + SUF and those using a 3WSC. Methods An RCT with 1096 patients in 5 adult intensive care units was conducted between April 2012 and August 2014 to evaluate their impact on CLABSI rates. Centers for Disease Control and Prevention/National Healthcare Safety Network definitions were applied and International Nosocomial Infection Control Consortium methodology were followed. Results The study cohort included 547 patients and 3619 central line (CL)-days for the SS + SUF group, and 549 patients and 4061 CL-days for the 3WSC group. CLABSI rates were 2.21 per 1000 CL-days for SS + SUF and 6.40 per 1000 CL-days for 3WSC (relative risk, 0.35; 95% confidence interval [CI], 0.16-0.76; P =.006). The SS + SUF group had significantly better cumulative infection-free catheter survival compared with the 3WSC group (hazard ration, 0.33; 95% CI, 0.15-0.73; P =.006). Using an SS + SUF represents savings of $402.88 and an increase in quality-adjusted life years of 0.0008 per patient. For each extra dollar invested in an SS + SUF, $124 was saved. Conclusion The use of SS + SUF is cost-effective and associated with a significantly lower CLABSI rate compared with the use of 3WSC.
Fil: Rosenthal, Victor Daniel. Comunidad Científica Internacional de Control de Infecciones Nosocomiales; Argentina
Fil: Udwadia, Farokh Earch. Breach Candy Hospital Trust; India
Fil: Kumar, Siva. Kovai Medical Center and Hospital; India
Fil: Poojary, Aruna. Breach Candy Hospital Trust; India
Fil: Sankar, Rathi. Kovai Medical Center and Hospital; India
Fil: Orellano, Pablo Wenceslao. Comunidad Científica Internacional de Control de Infecciones Nosocomiales; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Durgad, Shilpa. Breach Candy Hospital Trust; India
Fil: Thulasiraman, Mahendran. Kovai Medical Center and Hospital; India
Fil: Bahirune, Shweta. Breach Candy Hospital Trust; India
Fil: Kumbhar, Shubhangi. Breach Candy Hospital Trust; India
Fil: Patil, Priyanka. Breach Candy Hospital Trust; India
Materia
BACTEREMIA
CATHETER-RELATED INFECTION
DEVELOPING COUNTRIES
HEALTH CARE-ACQUIRED INFECTION
HOSPITAL INFECTION
INTENSIVE CARE UNIT
RANDOMIZED CLINICAL TRIAL
SINGLE-USE PREFILLED FLUSHING DEVICE
SPLIT SEPTUM
THREE-WAY STOPCOCK
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/97495
Acceder
id CONICETDig_1e671497affbbbf0da0fdb0ac9879909
oai_identifier_str oai:ri.conicet.gov.ar:11336/97495
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)Rosenthal, Victor DanielUdwadia, Farokh EarchKumar, SivaPoojary, ArunaSankar, RathiOrellano, Pablo WenceslaoDurgad, ShilpaThulasiraman, MahendranBahirune, ShwetaKumbhar, ShubhangiPatil, PriyankaBACTEREMIACATHETER-RELATED INFECTIONDEVELOPING COUNTRIESHEALTH CARE-ACQUIRED INFECTIONHOSPITAL INFECTIONINTENSIVE CARE UNITRANDOMIZED CLINICAL TRIALSINGLE-USE PREFILLED FLUSHING DEVICESPLIT SEPTUMTHREE-WAY STOPCOCKhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background Three-way stopcocks (3WSCs) are open systems used on intravenous tubing. Split septums (SSs) are closed systems with prepierced septums. Single-use prefilled flushing devices (SUFs) carry a lower risk of contamination than standard intravenous flushing. 3WSC and standard flushing are widely used in developing countries. This is the first randomized clinical trial (RCT) to compare rates of central line-associated bloodstream infection (CLABSI) between patients using an SS + SUF and those using a 3WSC. Methods An RCT with 1096 patients in 5 adult intensive care units was conducted between April 2012 and August 2014 to evaluate their impact on CLABSI rates. Centers for Disease Control and Prevention/National Healthcare Safety Network definitions were applied and International Nosocomial Infection Control Consortium methodology were followed. Results The study cohort included 547 patients and 3619 central line (CL)-days for the SS + SUF group, and 549 patients and 4061 CL-days for the 3WSC group. CLABSI rates were 2.21 per 1000 CL-days for SS + SUF and 6.40 per 1000 CL-days for 3WSC (relative risk, 0.35; 95% confidence interval [CI], 0.16-0.76; P =.006). The SS + SUF group had significantly better cumulative infection-free catheter survival compared with the 3WSC group (hazard ration, 0.33; 95% CI, 0.15-0.73; P =.006). Using an SS + SUF represents savings of $402.88 and an increase in quality-adjusted life years of 0.0008 per patient. For each extra dollar invested in an SS + SUF, $124 was saved. Conclusion The use of SS + SUF is cost-effective and associated with a significantly lower CLABSI rate compared with the use of 3WSC.Fil: Rosenthal, Victor Daniel. Comunidad Científica Internacional de Control de Infecciones Nosocomiales; ArgentinaFil: Udwadia, Farokh Earch. Breach Candy Hospital Trust; IndiaFil: Kumar, Siva. Kovai Medical Center and Hospital; IndiaFil: Poojary, Aruna. Breach Candy Hospital Trust; IndiaFil: Sankar, Rathi. Kovai Medical Center and Hospital; IndiaFil: Orellano, Pablo Wenceslao. Comunidad Científica Internacional de Control de Infecciones Nosocomiales; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Durgad, Shilpa. Breach Candy Hospital Trust; IndiaFil: Thulasiraman, Mahendran. Kovai Medical Center and Hospital; IndiaFil: Bahirune, Shweta. Breach Candy Hospital Trust; IndiaFil: Kumbhar, Shubhangi. Breach Candy Hospital Trust; IndiaFil: Patil, Priyanka. Breach Candy Hospital Trust; IndiaMosby-Elsevier2015-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/97495Rosenthal, Victor Daniel; Udwadia, Farokh Earch; Kumar, Siva; Poojary, Aruna; Sankar, Rathi; et al.; Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC); Mosby-Elsevier; American Journal Of Infection Control; 43; 10; 10-2015; 1040-10450196-6553CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0196655315006550info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ajic.2015.05.042info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:56:48Zoai:ri.conicet.gov.ar:11336/97495instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:56:49.267CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
title Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
spellingShingle Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
Rosenthal, Victor Daniel
BACTEREMIA
CATHETER-RELATED INFECTION
DEVELOPING COUNTRIES
HEALTH CARE-ACQUIRED INFECTION
HOSPITAL INFECTION
INTENSIVE CARE UNIT
RANDOMIZED CLINICAL TRIAL
SINGLE-USE PREFILLED FLUSHING DEVICE
SPLIT SEPTUM
THREE-WAY STOPCOCK
title_short Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
title_full Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
title_fullStr Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
title_full_unstemmed Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
title_sort Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC)
dc.creator.none.fl_str_mv Rosenthal, Victor Daniel
Udwadia, Farokh Earch
Kumar, Siva
Poojary, Aruna
Sankar, Rathi
Orellano, Pablo Wenceslao
Durgad, Shilpa
Thulasiraman, Mahendran
Bahirune, Shweta
Kumbhar, Shubhangi
Patil, Priyanka
author Rosenthal, Victor Daniel
author_facet Rosenthal, Victor Daniel
Udwadia, Farokh Earch
Kumar, Siva
Poojary, Aruna
Sankar, Rathi
Orellano, Pablo Wenceslao
Durgad, Shilpa
Thulasiraman, Mahendran
Bahirune, Shweta
Kumbhar, Shubhangi
Patil, Priyanka
author_role author
author2 Udwadia, Farokh Earch
Kumar, Siva
Poojary, Aruna
Sankar, Rathi
Orellano, Pablo Wenceslao
Durgad, Shilpa
Thulasiraman, Mahendran
Bahirune, Shweta
Kumbhar, Shubhangi
Patil, Priyanka
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv BACTEREMIA
CATHETER-RELATED INFECTION
DEVELOPING COUNTRIES
HEALTH CARE-ACQUIRED INFECTION
HOSPITAL INFECTION
INTENSIVE CARE UNIT
RANDOMIZED CLINICAL TRIAL
SINGLE-USE PREFILLED FLUSHING DEVICE
SPLIT SEPTUM
THREE-WAY STOPCOCK
topic BACTEREMIA
CATHETER-RELATED INFECTION
DEVELOPING COUNTRIES
HEALTH CARE-ACQUIRED INFECTION
HOSPITAL INFECTION
INTENSIVE CARE UNIT
RANDOMIZED CLINICAL TRIAL
SINGLE-USE PREFILLED FLUSHING DEVICE
SPLIT SEPTUM
THREE-WAY STOPCOCK
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background Three-way stopcocks (3WSCs) are open systems used on intravenous tubing. Split septums (SSs) are closed systems with prepierced septums. Single-use prefilled flushing devices (SUFs) carry a lower risk of contamination than standard intravenous flushing. 3WSC and standard flushing are widely used in developing countries. This is the first randomized clinical trial (RCT) to compare rates of central line-associated bloodstream infection (CLABSI) between patients using an SS + SUF and those using a 3WSC. Methods An RCT with 1096 patients in 5 adult intensive care units was conducted between April 2012 and August 2014 to evaluate their impact on CLABSI rates. Centers for Disease Control and Prevention/National Healthcare Safety Network definitions were applied and International Nosocomial Infection Control Consortium methodology were followed. Results The study cohort included 547 patients and 3619 central line (CL)-days for the SS + SUF group, and 549 patients and 4061 CL-days for the 3WSC group. CLABSI rates were 2.21 per 1000 CL-days for SS + SUF and 6.40 per 1000 CL-days for 3WSC (relative risk, 0.35; 95% confidence interval [CI], 0.16-0.76; P =.006). The SS + SUF group had significantly better cumulative infection-free catheter survival compared with the 3WSC group (hazard ration, 0.33; 95% CI, 0.15-0.73; P =.006). Using an SS + SUF represents savings of $402.88 and an increase in quality-adjusted life years of 0.0008 per patient. For each extra dollar invested in an SS + SUF, $124 was saved. Conclusion The use of SS + SUF is cost-effective and associated with a significantly lower CLABSI rate compared with the use of 3WSC.
Fil: Rosenthal, Victor Daniel. Comunidad Científica Internacional de Control de Infecciones Nosocomiales; Argentina
Fil: Udwadia, Farokh Earch. Breach Candy Hospital Trust; India
Fil: Kumar, Siva. Kovai Medical Center and Hospital; India
Fil: Poojary, Aruna. Breach Candy Hospital Trust; India
Fil: Sankar, Rathi. Kovai Medical Center and Hospital; India
Fil: Orellano, Pablo Wenceslao. Comunidad Científica Internacional de Control de Infecciones Nosocomiales; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Durgad, Shilpa. Breach Candy Hospital Trust; India
Fil: Thulasiraman, Mahendran. Kovai Medical Center and Hospital; India
Fil: Bahirune, Shweta. Breach Candy Hospital Trust; India
Fil: Kumbhar, Shubhangi. Breach Candy Hospital Trust; India
Fil: Patil, Priyanka. Breach Candy Hospital Trust; India
description Background Three-way stopcocks (3WSCs) are open systems used on intravenous tubing. Split septums (SSs) are closed systems with prepierced septums. Single-use prefilled flushing devices (SUFs) carry a lower risk of contamination than standard intravenous flushing. 3WSC and standard flushing are widely used in developing countries. This is the first randomized clinical trial (RCT) to compare rates of central line-associated bloodstream infection (CLABSI) between patients using an SS + SUF and those using a 3WSC. Methods An RCT with 1096 patients in 5 adult intensive care units was conducted between April 2012 and August 2014 to evaluate their impact on CLABSI rates. Centers for Disease Control and Prevention/National Healthcare Safety Network definitions were applied and International Nosocomial Infection Control Consortium methodology were followed. Results The study cohort included 547 patients and 3619 central line (CL)-days for the SS + SUF group, and 549 patients and 4061 CL-days for the 3WSC group. CLABSI rates were 2.21 per 1000 CL-days for SS + SUF and 6.40 per 1000 CL-days for 3WSC (relative risk, 0.35; 95% confidence interval [CI], 0.16-0.76; P =.006). The SS + SUF group had significantly better cumulative infection-free catheter survival compared with the 3WSC group (hazard ration, 0.33; 95% CI, 0.15-0.73; P =.006). Using an SS + SUF represents savings of $402.88 and an increase in quality-adjusted life years of 0.0008 per patient. For each extra dollar invested in an SS + SUF, $124 was saved. Conclusion The use of SS + SUF is cost-effective and associated with a significantly lower CLABSI rate compared with the use of 3WSC.
publishDate 2015
dc.date.none.fl_str_mv 2015-10
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/97495
Rosenthal, Victor Daniel; Udwadia, Farokh Earch; Kumar, Siva; Poojary, Aruna; Sankar, Rathi; et al.; Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC); Mosby-Elsevier; American Journal Of Infection Control; 43; 10; 10-2015; 1040-1045
0196-6553
CONICET Digital
CONICET
url http://hdl.handle.net/11336/97495
identifier_str_mv Rosenthal, Victor Daniel; Udwadia, Farokh Earch; Kumar, Siva; Poojary, Aruna; Sankar, Rathi; et al.; Clinical impact and cost-effectiveness of split-septum and single-use prefilled flushing device vs 3-way stopcock on central line-associated bloodstream infection rates in India: A randomized clinical trial conducted by the International Nosocomial Infection Control Consortium (INICC); Mosby-Elsevier; American Journal Of Infection Control; 43; 10; 10-2015; 1040-1045
0196-6553
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0196655315006550
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ajic.2015.05.042
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Mosby-Elsevier
publisher.none.fl_str_mv Mosby-Elsevier
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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