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Published online: 5 August 2020
© Springer Nature Switzerland AG 2020
Abstract
Central line-associated bloodstream infections (CLABSIs) are primary, laboratory confirmed bloodstream infections in patients with a central line within 48 h of symptom onset. Catheter-related bloodstream infection (CRBSI) is a more specific term used when the cause of infection has been confirmed by catheter tip cultures. CLABSIs and CRBSIs occur as a result of bacteraemia originating from intravenous catheters. Bloodstream infections are associated with increased length of stay, mortality and increased cost in treatment. The ability of Curos™, a disinfecting cap for needleless connectors of vascular access lines, to prevent bloodstream infections was considered by the National Institute of Health and Care Excellence (NICE) as part of the Medical Technologies Evaluation Programme (MTEP). Curos is a single-use device that contains a foam that is impregnated with 70% isopropyl alcohol; use of Curos is claimed to avoid the need to manually disinfect needleless connectors. Curos disinfection caps may contribute to the prevention of CLABSIs and CRBSIs as part of a bundle of infection prevention processes; however, the evidence for Curos is limited in both quantity and quality and may not be generalisable to National Health Service (NHS) practice. Therefore, the guidance published by NICE in May 2019 recommended further research to address uncertainties regarding the clinical benefits of using Curos.
1Introduction
This paper is part of a series that provides an insight into the development of National Institute for Health and Care Excellence (NICE) Medical Technologies Guidance (MTG) [1]. The NICE produces guidance on new or innovative medical devices or diagnostics-MTG. The aim of the guidance is to support adoption of clinically effective and cost-saving technologies in the UK National Health Service.
This paper summarises Cedar's assessment report [2] and how it was used to inform the NICE MTG on Curos™ disinfection caps for the prevention of infection in needleless connectors (MTG44) [3]. Cedar is a healthcare technology research centre formed through collaboration between Cardiff and Vale University Health Board and Cardiff University. The aim of this paper is to provide an insight into the development of recommendations for the use of Curos disinfection caps.
1.1 Background to Technology and Application
Curos™ disinfection caps contain a sponge that is impregnated with 70% isopropyl alcohol,...