Optimal Disinfection Times for Needleless Intravenous Connectors |
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| Authors: | Judy S. Smith Gwen Irwin Mary Viney Lynda Watkins Shonnie Pinno Morris Kenn M. Kirksey Adama Brown |
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| Affiliation: | 1. University of Technology Sydney, Graduate School of Health (Pharmacy), Sydney, Australia;2. The University of Sydney, Faculty of Medicine and Health, Australia;3. Long Island University, College of Pharmacy, New York, United States;4. University of Technology Sydney, Graduate School of Health (Clinical Psychology), PO Box 123, Broadway, NSW 2007, Australia;5. University of Technology Sydney, Graduate School of Health (Biostatistician), PO Box 123, Broadway, NSW 2007, Australia;6. School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff CF10 3NB, Wales, UK;1. University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, Germany;2. Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany;3. German Centre for Infection Research (DZIF), Bonn, Cologne, Germany;4. Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany;5. Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany |
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| Abstract: | BackgroundElimination of catheter-related bloodstream infections is a major focus in health care. According to the Centers for Disease Control and Prevention and the Infusion Nurses Society, the optimal time for needleless connector disinfection has not yet been empirically established.MethodsUsing experimental design and established lab procedure, a 0.5 MacFarland suspension was used to inoculate 172 needleless connectors with bacteria (Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa) and allowed to dry for 18 hours. Five groups of connectors (n = 27 per group) were disinfected using 70% isopropyl alcohol with friction for 5, 8, 10, 12, and 15 seconds, and flushed with 0.5 mL nonbacteriostatic sterile normal saline onto sheep-blood agar plates for incubation at 35°C for 48 hours. Bacterial growth (1 colony) was noted on 2 negative controls; therefore, a second sample (n = 172) was tested as above using additional precautions of masking, gloving, and gowning. A third group of connectors was tested using a 0.5 MacFarland suspension containing yeast (Candida albicans).ResultsGroup 1 showed significant (χ24 = 37.93; P = .00) and strong (Cramér's V = 0.53; P = .00) associations between scrub time and growth status. Although not statistically significant, Groups 2 and 3 demonstrated clinically significant associations between these factors.ConclusionsAlthough additional research is warranted, our study showed that disinfection times of 5 and 8 seconds were inadequate for reducing bacterial transfer. However, disinfection times of 10, 12, and 15 seconds resulted in comparable, decreased rates of bacterial migration. |
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