Response to a letter to the editor regarding "connectors as a risk factor for blood-associated infections (3-way stopcock and needleless connector): a randomized-experimental study"

Abstract

In our study, “Results of this study found no significant difference between rates of colonization in NCs and TWSs,” this sentence was perceived as a contradiction. This contradiction was explained in the letter by Devrim. In our study, as indicated by Devrim, there was a difference in the rate of colonization in needleless connectors (NC) and 3-way stopcock (TWS) attached to peripheral venous catheters, but no statistically significant difference was found in the rate of colonization in central and port catheters. This is stated in the abstract section with the following sentence: “When the results of colonization for patients using TWS and NC were compared, the peripheral venous catheters (using a TWS) resulted in a significantly higher increase in reproduction than patients using NC (P ≤ .01) and no significant difference in the level of colonization in other types of connectors or catheters (P ˃ .05).” The results section is associated with the other data obtained; it has been emphasized that connectors attached to intravenous (IV) catheters are a risk factor for catheter-related bloodstream infections.

In addition, it is necessary for a scientific research to reach a general conclusion by discussing the findings with other literature. Indeed, studies comparing the effect of periferal intravenous catheter- integrated NC and TWS on the causing of infection are very limited, and available studies2,3 state that there is no difference between the 2 types of connectors. In addition, the number of injections, duration of use of the device, and microbial contamination rate were not confounders in both studies. In our study, the procedure for obtaining the culture from the connectors was carried out with attention, and this was stated in the study. Standard maintenance of catheters and connectors are summarized in Table 1. This table could not be shown in the study due to the publication standards of the Journal, but the process was summarized. In addition, clinical examinations of the patients were made in terms of signs of infection and body temperature measurements, and laboratory findings (C-reactive protein and blood leukocyte levels) were evaluated.