{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:50:16Z","timestamp":1791809416438,"version":"4.3.4"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26104474_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether split septum needleless connector prevent central line-associated bloodstream infection (CLABSI) better than mechanical valve in very preterm or very low-birth-weight (VLBW) neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104474_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This is an open-label, parallel, randomized controlled trial. Participants were followed up to 48 hours after central line removal for the primary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104474_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>This is a single-center study conducted at level III neonatal intensive care unit in public tertiary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104474_as4\">\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Very premature or VLBW neonates requiring central access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104474_as5\">\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>Participants were randomized to receive either a split septum or mechanical valve needleless connector.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104474_as6\">\n                    <jats:title>Primary Outcome:<\/jats:title>\n                    <jats:p>The primary outcomes were CLABSI incidence rate and the estimated hazard ratio of CLABSI between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104474_as7\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 60 neonates were included in the analysis, in which 30 neonates were allocated to each intervention (split septum) (mean\u00b1SD gestational age, 27.37 \u00b1 7.7 weeks; 15 [50%] male) and control (mechanical valve) group (mean\u00b1SD gestational age, 30.27 \u00b1 2.7 weeks; 17 [56.7%] male). The CLABSI incidence rate was lower in the intervention group (3.0 vs 16.2 per 1,000 catheter days). The adjusted hazard ratio for the intervention compared to control group was 0.153 (95% CI 0.02\u20131.52;\n                      <jats:italic>P<\/jats:italic>\n                      = .109). Although not statistically significant, the control group demonstrated higher CLABSI-related mortality (7% vs 0%), length of stay (49.8 \u00b1 24.2 vs 42.3 \u00b1 23.8), and hospital cost (130.5 (79.4\u2013215.9) vs 104.1 (86.4\u2013152.7).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104474_as8\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Split septum demonstrated a trend in lower incidence of CLABSI. This result should be weighed carefully in determining the needleless connector type best suited for very preterm or VLBW neonates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10447","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T07:01:08Z","timestamp":1785999668000},"page":"985-991","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["The efficacy of needleless connector designs (split septum vs mechanical valve) on preventing central line-associated bloodstream infection (CLABSI) in very preterm or very low-birth-weight neonates: a randomized clinical trial"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-6244","authenticated-orcid":false,"given":"Putri Maharani Tristanita","family":"Marsubrin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"publisher"}],"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhamad Azharry Rully","family":"Sjahrullah","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"publisher"}],"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8843-9238","authenticated-orcid":false,"given":"Nurul Fajri","family":"Widyasari","sequence":"additional","affiliation":[{"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8907-842X","authenticated-orcid":false,"given":"Jessica Sylvania","family":"Oswari","sequence":"additional","affiliation":[{"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9461-1069","authenticated-orcid":false,"given":"Rosalina Dewi","family":"Roeslani","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"publisher"}],"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5776-9692","authenticated-orcid":false,"given":"R. Adhi Teguh Permana","family":"Iskandar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"publisher"}],"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2909-404X","authenticated-orcid":false,"given":"Distyayu","family":"Sukarja","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"publisher"}],"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2965-5938","authenticated-orcid":false,"given":"Ahmad","family":"Kautsar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"publisher"}],"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3467-4751","authenticated-orcid":false,"given":"Rinawati","family":"Rohsiswatmo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0116zj450","id-type":"ROR","asserted-by":"publisher"}],"name":"Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"S0899823X26104474_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2023.11.020"},{"key":"S0899823X26104474_ref3","first-page":"1","article-title":"Central line-associated bloodstream infection in infants admitted to a level III neonatal intensive care unit","volume":"69","author":"Nielsen","year":"2022","journal-title":"Dan Med J"},{"key":"S0899823X26104474_ref5","unstructured":"5. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}