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Contamination susceptibility of three needleless and one standard needle injection systems
1Department of Anaesthesia, Hamilton Health Sciences Corporation and McMaster University Faculty of Health Sciences, Ontario. hoamh@hotmail.com
Purpose:
To compare in vitro the contamination susceptibility of three needleless and one standard needle injection systems.
Methods:
The Baxter InterLink, St. Paul Medical Key-Lok, Braun SafSite, and Becton Dickinson heparin lock, were compared. Fifty of each were studied. Each system was connected to a culture bottle and injected 30 times over 72 hr. The manufacturers' directions were followed except for Braun's, which recommend that a new sterile cap be used after each injection. Instead, the same cap was used after each injection to reflect day-to-day clinical practice. Culture bottles were subsequently analyzed for bacterial growth.
Results:
The contamination rates for the heparin lock, InterLink, Key-Lok, and SafSite were 3/50 (6%), 6/50 (12%), 4/50 (8%), and 36/50 (72%), respectively. All positive cultures grew coagulase-negative staphylococcus species. There was no difference in contamination rates between the InterLink, Key-Lok, and heparin lock designs. The contamination rate of the SafSite was higher (P < 0.001) than the other three systems.
Conclusions:
The InterLink and Key-Lok systems had a similarly low contamination susceptibility as a standard needle injection system. It was not clear if the high contamination rate found with the SafSite system was due to non-adherence to the manufacturer's directions for handling.
Insights
Needleless injection systems, InterLink and Key-Lok, showed low contamination susceptibility comparable to standard needle systems. The SafSite system exhibited a significantly higher contamination rate in vitro.
Area of Science:
- Infection Control
- Medical Device Safety
- Microbiology
Background:
- Healthcare-associated infections remain a significant concern.
- Needleless injection systems aim to reduce needlestick injuries and infection transmission.
- Evaluating the microbial contamination risk of these devices is crucial for patient safety.
Purpose of the Study:
- To compare the in vitro contamination susceptibility of three needleless injection systems (Baxter InterLink, St. Paul Medical Key-Lok, Braun SafSite) against one standard needle injection system (Becton Dickinson heparin lock).
Main Methods:
- Fifty units of each injection system were tested.
- Each system was connected to a culture bottle and subjected to 30 injections over 72 hours.
- Manufacturer's directions were followed, with a modification for the Braun SafSite to reflect typical clinical practice (reusing the cap). Bacterial growth in culture bottles was analyzed.
Main Results:
- The contamination rates were: heparin lock (6%), InterLink (12%), Key-Lok (8%), and SafSite (72%).
- Coagulase-negative staphylococcus species were identified in all positive cultures.
- No significant difference in contamination rates was observed between the InterLink, Key-Lok, and heparin lock systems.
Conclusions:
- The Baxter InterLink and St. Paul Medical Key-Lok systems demonstrated contamination susceptibility similar to the standard Becton Dickinson heparin lock.
- The significantly higher contamination rate observed with the Braun SafSite warrants further investigation, potentially related to handling protocols.