Highlights
- •Antiseptic barrier caps appear to be effective in reducing CLABSI.
- •ICU patients, adults, and observational studies associated with significant benefit.
- •No benefit in children.
- •Compliance with antiseptic barrier cap use was high and costs were lower.
- •The real-world impact needs to be confirmed by RCTs.
Abstract
Objectives
To evaluate the evidence concerning the effectiveness of antiseptic barrier caps vs.
manual disinfection in preventing central line-associated bloodstream infection (CLABSI).
Methods
The protocol of this systematic review and meta-analysis was pre-registered in PROSPERO
(CRD42021259582). PubMed, Cochrane Library and Web of Science databases were searched
from 2011 to 2021. Randomized-controlled trials (RCT) and observational studies on
hospitalized patients of any age were included.
Results
Fourteen studies were included. Compared with manual disinfection, antiseptic barrier
caps significantly reduced CLABSI rate per 1000 line-days (Standardized Mean Difference
[SMD]: -0.02; 95%CI: -0.03 to -0.01) and number of CLABSI per patient (RR: 0.60; 95%CI:
0.41–0.89). Subgroup analysis showed that antiseptic barrier caps were more effective
in reducing CLABSI rate per 1000 line-days in ICU (SMD: -0.02; 95%CI: -0.03 to -0.01)
and non-ICU patients (SMD: -0.03; 95%CI: -0.05 to -0.01), adults (SMD: -0.02; 95%CI:
-0.04 to -0.01), as in observational studies (SMD: -0.02; 95%CI: -0.02 to -0.01).
Antiseptic barrier caps also significantly reduce CLABSI risk in ICU patients (RR:
0.65, 95%CI: 0.42–1.00), adults (RR: 0.50, 95%CI: 0.29–0.86), and observational studies
(RR: 0.54; 95%CI: 0.32–0.91). No differences were found when only children or RCTs
were taken into account. Median cost savings amongst studies were $21,890 [IQR 16,350–45,000]
per CLABSI.
Conclusions
Antiseptic barrier caps appear to be effective in reducing CLABSI. The real-world
impact needs to be confirmed by RCTs.
Keywords
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Article info
Publication history
Published online: February 10, 2022
Accepted:
January 31,
2022
Received in revised form:
January 24,
2022
Received:
September 22,
2021
Identification
Copyright
© 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
