Blood drawn through valved catheter hub connectors carries a significant risk of contamination |
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Authors: | R J Sherertz T B Karchmer E Palavecino and W Bischoff |
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Institution: | (1) Infectious Diseases Section, Department of Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1042, USA;(2) Becton Dickinson, San Diego, CA, USA;(3) Pathology Department, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA |
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Abstract: | Infection Control became concerned when bloodstream infection (BSI) rates increased after implementing a needleless valved
hub connector. During a 21-month period three different needleless catheter hub connectors were evaluated by quantitatively
culturing blood drawn through hub connectors that would have ordinarily been discarded (DBC). DBC drawn through Clearlink™
catheter hub connectors were found to be twice as likely to be positive as DBC drawn through Clave? or Q-syte™ hub connectors
(P < 0.04). DBC grew pathogens 46% of the time and skin organisms 54% of the time. Patients with positive DBC were three times
more likely to meet Centers for Disease Control (CDC) BSI criteria by DBC cultures than by physician-ordered blood cultures
(CBC; P < 0.001). For patients growing pathogens in DBC, 64% had no CBC drawn, the average temperature was lower than for patients
with pathogens in CBC (99.3 ± 1.5 ve 100.6 ± 1.9, P = 0.015), and 92% of discharged patients (11 out of 12) were not treated with an antibiotic active against the DBC pathogen.
Drawing BC through a catheter hub connector carries a risk of false-positives that could increase BSI rates by up to 3-fold.
Further work is necessary to evaluate this concern. |
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