NCT02351258

Brief Summary

The overall goal of this Community Central Line Infection Prevention (CCLIP) trial, supported by grant R01 HS022870 from the Agency for Healthcare Research and Quality, is to determine whether use of a promising new intervention, namely 70% isopropyl alcohol embedded protective caps on central lines, in the home setting is associated with a reduction in ambulatory central line-associated bloodstream infections (CLABSI) in a high-risk population of pediatric hematology/oncology patients. Despite successes in CLABSI reduction efforts for inpatients, it remains unknown what generalizable best practices should be with chronic central lines in the home setting and how effective involving patients and caregivers across multiple institutions in CLABSI reduction efforts will be. This research will involve a cluster-randomized, cross-over design, clinical trial. This proposal will focus on the caregivers integral to ambulatory pediatric central line care: patients and families. The specific aims of the proposed research program are: Specific Aim #1: Evaluate whether use of 70% isopropyl alcohol embedded protective caps on central lines reduces the rate of CLABSI in ambulatory pediatric hematology/oncology patients. Hypothesis: Use of 70% isopropyl alcohol embedded protective caps on central lines will be associated with at least a 25% reduction in the ambulatory CLABSI rate for pediatric hematology/oncology patients. Specific Aim #2: Evaluate whether use of 70% isopropyl alcohol embedded protective caps on central lines reduces the rate of all positive blood cultures in ambulatory pediatric hematology/oncology patients. Hypothesis: Use of 70% isopropyl alcohol embedded protective caps on central lines will be associated with at least a 25% reduction in the positive blood culture rate at home for pediatric hematology/oncology patients. Specific Aim #3: Evaluate whether the use of 70% isopropyl alcohol embedded protective caps on central lines changes the distribution of bacteria isolated from blood cultures of pediatric hematology/oncology patients. Hypothesis: Use of 70% isopropyl alcohol embedded protective caps on central lines will reduce Gram-positive CLABSI, secondary blood steam infections, and single positive blood cultures at home for pediatric hematology/oncology patients.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
16

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Nov 2015

Longer than P75 for not_applicable

Geographic Reach
1 country

16 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 27, 2015

Completed
3 days until next milestone

First Posted

Study publicly available on registry

January 30, 2015

Completed
9 months until next milestone

Study Start

First participant enrolled

November 1, 2015

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 9, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 9, 2019

Completed
8 months until next milestone

Results Posted

Study results publicly available

May 20, 2020

Completed
Last Updated

May 20, 2020

Status Verified

May 1, 2020

Enrollment Period

3.9 years

First QC Date

January 27, 2015

Results QC Date

May 5, 2020

Last Update Submit

May 5, 2020

Conditions

Keywords

PediatricsMedical OncologyCathetersInfection

Outcome Measures

Primary Outcomes (1)

  • Total Number of Central Line Associated Blood Stream Infections (CLABSI)

    To obtain rate of ambulatory central line associated blood stream infections in ambulatory patients

    2 years

Secondary Outcomes (5)

  • Total Number of Mucosal Barrier Injury Central Line-associated Bloodstream Infections (MBI-CLABSI)

    2 years

  • Total Number of Ambulatory Secondary Bloodstream Infections (Secondary BSI)

    2 years

  • Total Number of Ambulatory Single Positive Blood Cultures (SPBC)

    2 years

  • Total Number of Ambulatory Positive Blood Culture

    2 years

  • Total Number of Acquired Pathogens

    2 years

Study Arms (2)

Usual Care only, then Usual Care + 70% Isopropyl Alcohol

EXPERIMENTAL

Usual care for central line while patients are at home and then switch to usual care plus 70% isopropyl alcohol after washout.

Device: 70% Isopropyl alcohol embedded capsOther: Usual Care

Usual Care + 70% Isopropyl Alcohol, then Usual Care only

EXPERIMENTAL

Use of 70% isopropyl alcohol embedded caps on central lines in addition to usual care of central line in the home setting and then switch to usual care only after washout.

Device: 70% Isopropyl alcohol embedded capsOther: Usual Care

Interventions

Protective cap on central lines

Also known as: Curos Cap by Ivera Medical Corporation
Usual Care + 70% Isopropyl Alcohol, then Usual Care onlyUsual Care only, then Usual Care + 70% Isopropyl Alcohol

This involves the Best Practice Central Line Maintenance Care Bundle which includes; 1. Daily assessment whether central line is needed 2. Central line Site Care 3. Central line Hub/Cap/Tubing Care

Usual Care + 70% Isopropyl Alcohol, then Usual Care onlyUsual Care only, then Usual Care + 70% Isopropyl Alcohol

Eligibility Criteria

Age1 Day - 35 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • pediatric outpatients with either hematologic or oncologic diagnosis who have an external central line

You may not qualify if:

  • none

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (16)

Children's Hospital of Alabama

Birmingham, Alabama, 35233, United States

Location

Arkansas Children's Hospital

Little Rock, Arkansas, 72202, United States

Location

Children's Hospital of Colorado

Aurora, Colorado, 80045, United States

Location

Nemours Alfred Dupont Hospital for Children

Wilmington, Delaware, 19603, United States

Location

University of Florida Children's Hospital

Gainesville, Florida, 32608, United States

Location

Norton Children's Hospital

Louisville, Kentucky, 40202, United States

Location

Johns Hopkins Children's Center

Baltimore, Maryland, 21287, United States

Location

Johns Hopkins University

Baltimore, Maryland, 21287, United States

Location

Children's Hospital of Michigan

Detroit, Michigan, 48201, United States

Location

St Louis Children's Hospital

St Louis, Missouri, 63110, United States

Location

Children's Hospital of Montefiore

The Bronx, New York, 10467, United States

Location

Akron Children's Hospital

Akron, Ohio, 44308, United States

Location

Nationwide Children's Hospital

Columbus, Ohio, 43205, United States

Location

Doernbecher Children's Hospital

Portland, Oregon, 97239, United States

Location

Medical University of South Carolina Children's Hospital

Charleston, South Carolina, 29425, United States

Location

Texas Children's Hospital

Houston, Texas, 77030, United States

Location

Related Publications (1)

  • Milstone AM, Rosenberg C, Yenokyan G, Koontz DW, Miller MR; CCLIP Authorship Group. Alcohol-impregnated caps and ambulatory central-line-associated bloodstream infections (CLABSIs): A randomized clinical trial. Infect Control Hosp Epidemiol. 2021 Apr;42(4):431-439. doi: 10.1017/ice.2020.467. Epub 2020 Oct 12.

MeSH Terms

Conditions

Infections

Results Point of Contact

Title
Dr. Aaron Milstone
Organization
Johns Hopkins University

Study Officials

  • Marlene R. Miller, MD, MSc

    University Hospitals

    PRINCIPAL INVESTIGATOR
  • Aaron Milstone, MD, MHS

    Johns Hopkins University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 27, 2015

First Posted

January 30, 2015

Study Start

November 1, 2015

Primary Completion

September 9, 2019

Study Completion

September 9, 2019

Last Updated

May 20, 2020

Results First Posted

May 20, 2020

Record last verified: 2020-05

Data Sharing

IPD Sharing
Will not share

Participating individuals are at the hospital level via hospital ambulatory central line infection rates

Locations