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Disinfection of vascular catheter connectors that are protected by antiseptic caps is unnecessary

Published online by Cambridge University Press:  19 July 2023

Kelsey M. Fillman ,
Jonathan H. Ryder Open the ORCID record for Jonathan H. Ryder [Opens in a new window] ,
Daniel M. Brailita Open the ORCID record for Daniel M. Brailita [Opens in a new window] ,
Mark E. Rupp Open the ORCID record for Mark E. Rupp [Opens in a new window] ,
R. Jennifer Cavalieri Open the ORCID record for R. Jennifer Cavalieri [Opens in a new window] ,
Paul D. Fey ,
Elizabeth R. Lyden Open the ORCID record for Elizabeth R. Lyden [Opens in a new window]  and
Richard J. Hankins Open the ORCID record for Richard J. Hankins [Opens in a new window]
Kelsey M. Fillman
Affiliation:
University of Nebraska Medical Center, Omaha, Nebraska
Jonathan H. Ryder
Affiliation:
Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
Daniel M. Brailita
Affiliation:
Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
Mark E. Rupp
Affiliation:
Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
R. Jennifer Cavalieri
Affiliation:
Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
Paul D. Fey
Affiliation:
Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
Elizabeth R. Lyden
Affiliation:
Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska
Richard J. Hankins*
Affiliation:
Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
*
Corresponding author: Richard J. Hankins; Email: Richard.hankins@unmc.edu
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Abstract

Objective:

Determination of whether vascular catheter disinfecting antiseptic-containing caps alone are effective at decreasing microbial colonization of connectors compared to antiseptic-containing caps plus a 5-second alcohol manual disinfection.

Setting:

The study was conducted in a 718-bed, tertiary-care, academic hospital.

Patients:

A convenience sample of adult patients across intensive care units and acute care wards with peripheral and central venous catheters covered with antiseptic-containing caps.

Methods:

Quality improvement study completed over 5 days. The standard-of-care group consisted of catheter connectors with antiseptic-containing caps cleaned with a 5-second alcohol wipe scrub prior to culture. The comparison group consisted of catheter connectors with antiseptic-containing caps without a 5-second alcohol wipe scrub prior to culture. The connectors were pressed directly onto blood agar plates and incubated. Plates were assessed for growth after 48-72 hours.

Results:

In total, 356 catheter connectors were cultured: 165 in the standard-of-care group, 165 in the comparison group, and 26 catheters connectors without an antiseptic-containing cap, which were designated as controls. Overall, 18 catheter connectors (5.06%) yielded microbial growth. Of the 18 connectors with microbial growth, 2 (1.21%) were from the comparison group, 1 (0.61%) was from the standard-of-care group, and 15 were controls without an antiseptic-containing cap.

Conclusions:

Bacterial colonization rates were similar between the catheter connectors cultured with antiseptic-containing caps alone and catheter connectors with antiseptic-containing caps cultured after a 5-second scrub with alcohol. This finding suggests that the use of antiseptic-containing caps precludes the need for additional disinfection.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 45 , Issue 1 , January 2024 , pp. 35 - 39
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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