Ishizuka, M., Nagata, H., Takagi, K., & Kubota, K. (2013). Needleless closed system does not reduce central venous catheter-related bloodstream infection: A retrospective study. International Surgery, 98, 88–93.
To determine whether a needleless closed system (NCS) is superior to the Luer cap system (LCS) in regards to the prevention of catheter-related bloodstream infection.
This was a retrospective study comparing the length of time from central venous catheter (CVC) insertion to the development of central-line associated blood stream infection (CLABSI) using LCS and then switching to NCS.
Retrospective analysis
The authors measured the time interval from CVC insertion to the development of CLABSI and compared a group of patients using LCS to a group using NCS. Centers for Disease Control (CDC) guidelines were used to define and diagnose CLABSI.
Using the Kaplan-Meier estimate and the log-rank test, the authors found that there was no significant difference between the LCS group and the NCS group in the time interval from CVC insertion to onset of CLABSI. Similarly, there was no significant difference in the incidence of CLABSI (p = 0.3), blood culture positivity (p = 0.836), and CVC tip positivity (p = 0.116) between the two groups.
There was no significant difference between the two groups in regard to blood culture positivity, CVC tip culture positivity, or the incidence of CLABSI. NCS did not demonstrate superiority in terms of prevention of CLABSI.
Although they were not shown to reduce CLABSI, NCSs are still recommended as a means of preventing needle-stick injuries.