A randomized, prospective clinical trial to assess the potential infection risk associated with the PosiFlow® needleless connector

A Casey, Tony Worthington, Peter A. Lambert, D. Quinn, M.H. Faroqui, T.S.J. Elliott

Research output: Contribution to journalArticle

Abstract

The microbial contamination rate of luers of central venous catheters (CVCs) with either PosiFlow® needleless connectors or standard caps attached was investigated. The efficacy of 70% (v/v) isopropyl alcohol, 0.5% (w/v) chlorhexidine in gluconate 70% (v/v) isopropyl alcohol and 10% (w/v) aqueous povidone-iodine to disinfect the intravenous connections was also assessed. Seventy-seven patients undergoing cardiac surgery who required a CVC as part of their clinical management were randomly allocated either needleless connectors or standard caps. Patients were also designated to receive chlorhexidine/alcohol, isopropyl alcohol or povidone-iodine for pre-CVC insertion skin preparation and disinfection of the connections. After 72 h in situ the microbial contamination rate of 580 luers, 306 with standard caps and 274 with needleless connectors attached, was determined. The microbial contamination rate of the external compression seals of 274 needleless connectors was also assessed to compare the efficacy of the three disinfectants. The internal surfaces of 55 out of 306 (18%) luers with standard caps were contaminated with micro-organisms, whilst only 18 out of 274 (6.6%) luers with needleless connectors were contaminated (P<0.0001). Of those needleless connectors disinfected with isopropyl alcohol, 69.2% were externally contaminated with micro-organisms compared with 30.8% disinfected with chlorhexidine/alcohol (P<0.0001) and 41.6% with povidone-iodine (P<0.0001). These results suggest that the use of needleless connectors may reduce the microbial contamination rate of CVC luers compared with the standard cap. Furthermore, disinfection of needleless connectors with either chlorhexidine/alcohol or povidone-iodine significantly reduced external microbial contamination. Both these strategies may reduce the risk of catheter-related infections acquired via the intraluminal route. © 2003 The Hospital Infection Society. Published by Elsevier Science Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)288-293
Number of pages6
JournalJournal of Hospital Infection
Volume54
Issue number4
DOIs
Publication statusPublished - Aug 2003

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Povidone-Iodine
2-Propanol
Central Venous Catheters
Randomized Controlled Trials
Chlorhexidine
Infection
Disinfection
Alcohols
Hospital Societies
Catheter-Related Infections
Disinfectants
Cross Infection
Thoracic Surgery
Skin

Keywords

  • catheter
  • contamination
  • disinfectant
  • needleless connector

Cite this

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title = "A randomized, prospective clinical trial to assess the potential infection risk associated with the PosiFlow{\circledR} needleless connector",
abstract = "The microbial contamination rate of luers of central venous catheters (CVCs) with either PosiFlow{\circledR} needleless connectors or standard caps attached was investigated. The efficacy of 70{\%} (v/v) isopropyl alcohol, 0.5{\%} (w/v) chlorhexidine in gluconate 70{\%} (v/v) isopropyl alcohol and 10{\%} (w/v) aqueous povidone-iodine to disinfect the intravenous connections was also assessed. Seventy-seven patients undergoing cardiac surgery who required a CVC as part of their clinical management were randomly allocated either needleless connectors or standard caps. Patients were also designated to receive chlorhexidine/alcohol, isopropyl alcohol or povidone-iodine for pre-CVC insertion skin preparation and disinfection of the connections. After 72 h in situ the microbial contamination rate of 580 luers, 306 with standard caps and 274 with needleless connectors attached, was determined. The microbial contamination rate of the external compression seals of 274 needleless connectors was also assessed to compare the efficacy of the three disinfectants. The internal surfaces of 55 out of 306 (18{\%}) luers with standard caps were contaminated with micro-organisms, whilst only 18 out of 274 (6.6{\%}) luers with needleless connectors were contaminated (P<0.0001). Of those needleless connectors disinfected with isopropyl alcohol, 69.2{\%} were externally contaminated with micro-organisms compared with 30.8{\%} disinfected with chlorhexidine/alcohol (P<0.0001) and 41.6{\%} with povidone-iodine (P<0.0001). These results suggest that the use of needleless connectors may reduce the microbial contamination rate of CVC luers compared with the standard cap. Furthermore, disinfection of needleless connectors with either chlorhexidine/alcohol or povidone-iodine significantly reduced external microbial contamination. Both these strategies may reduce the risk of catheter-related infections acquired via the intraluminal route. {\circledC} 2003 The Hospital Infection Society. Published by Elsevier Science Ltd. All rights reserved.",
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A randomized, prospective clinical trial to assess the potential infection risk associated with the PosiFlow® needleless connector. / Casey, A; Worthington, Tony; Lambert, Peter A.; Quinn, D.; Faroqui, M.H.; Elliott, T.S.J.

In: Journal of Hospital Infection, Vol. 54, No. 4, 08.2003, p. 288-293.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A randomized, prospective clinical trial to assess the potential infection risk associated with the PosiFlow® needleless connector

AU - Casey, A

AU - Worthington, Tony

AU - Lambert, Peter A.

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AU - Elliott, T.S.J.

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AB - The microbial contamination rate of luers of central venous catheters (CVCs) with either PosiFlow® needleless connectors or standard caps attached was investigated. The efficacy of 70% (v/v) isopropyl alcohol, 0.5% (w/v) chlorhexidine in gluconate 70% (v/v) isopropyl alcohol and 10% (w/v) aqueous povidone-iodine to disinfect the intravenous connections was also assessed. Seventy-seven patients undergoing cardiac surgery who required a CVC as part of their clinical management were randomly allocated either needleless connectors or standard caps. Patients were also designated to receive chlorhexidine/alcohol, isopropyl alcohol or povidone-iodine for pre-CVC insertion skin preparation and disinfection of the connections. After 72 h in situ the microbial contamination rate of 580 luers, 306 with standard caps and 274 with needleless connectors attached, was determined. The microbial contamination rate of the external compression seals of 274 needleless connectors was also assessed to compare the efficacy of the three disinfectants. The internal surfaces of 55 out of 306 (18%) luers with standard caps were contaminated with micro-organisms, whilst only 18 out of 274 (6.6%) luers with needleless connectors were contaminated (P<0.0001). Of those needleless connectors disinfected with isopropyl alcohol, 69.2% were externally contaminated with micro-organisms compared with 30.8% disinfected with chlorhexidine/alcohol (P<0.0001) and 41.6% with povidone-iodine (P<0.0001). These results suggest that the use of needleless connectors may reduce the microbial contamination rate of CVC luers compared with the standard cap. Furthermore, disinfection of needleless connectors with either chlorhexidine/alcohol or povidone-iodine significantly reduced external microbial contamination. Both these strategies may reduce the risk of catheter-related infections acquired via the intraluminal route. © 2003 The Hospital Infection Society. Published by Elsevier Science Ltd. All rights reserved.

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KW - disinfectant

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