Bloodstream infections associated with a needleless intravenous infusion system in patients receiving home infusion therapy.

Objective. —To determine risk factors for bloodstream infections (BSIs) in an outbreak among patients receiving home intravenous infusion therapy. Desing. —Case-control and retrospective cohort studies. Setting. —Home health agency. Patients. —Patients receiving home intravenous infusion therapy from Rhode Island Home Therapeutics (RIHT) from January through December 1993. Main Outcome Measure. —Development of primary BSI. Methods. —We compared patients with BSI (ie, case patients) with randomly selected noninfected RIHT patients receiving intravenous therapy, conducted a cohort study of all RIHT patients receiving intravenous therapy via a central venous catheter (CVC), and conducted a culture survey of injection cap luminal fluid. Results. —Case patients were more likely than controls to have had therapy via a CVC (11/11 vs 14/32; odds ratio [OR] undefined; P P P =.04). Conclusions. —Our data suggest that a needleless device used for TPN/IL was associated with increased risk of BSI when injection caps were changed every 7 days. ( JAMA . 1995;273:1862-1864)