Comparison of contamination between conventional three-way stopcock and needleless injection device: a randomized controlled trial.

BACKGROUND: Intraluminal contamination of catheter hubs has been recognized as the most frequent cause of catheter-related blood stream infections. We have investigated the efficacy of a new hub device, Planecta SC(R) (PNSC), in preventing endoluminal catheter contamination, compared to a conventional three-way stopcock. MATERIAL/METHODS: Adults patients requiring an intravascular catheter placement for at least 48 hours in intensive care units were randomly assigned to receive either the infusion device with the newly designed hub, PNSC (P group, n=89), or with a conventional three-way stopcock (C group, n=73). To evaluate intraluminal contamination, we examined the bacteria isolated in the inline bacterial filters which were attached to downstream of the injection ports. In addition to the clinical study, we conducted a bench study to investigate if use of protection caps or strict disinfection technique prevented intraluminal contamination with this new needleless connector. RESULTS: The incidence of bacterial contamination was not significantly different between the groups (P group 9/89 (10.1%) vs. C group 6/73 (8.2%), P=0.79). There was no correlation between the numbers of injections, duration of the use of the device or the microbial contamination rate. In the bench study, protection caps and disinfection technique significantly decreased microbial transfer from the hub to the fluid space. CONCLUSIONS: We concluded that the use of the new hub device did not reduce endoluminal bacterial contamination rate in comparison with that of a three way stopcock. Intraluminal bacterial contamination may be reduced by either strict disinfection technique or when a protection cap is use.