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Updated: Aug 29, 2026

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Published on: July 13, 2019
Improving water quality can reduce pyrogenic reactions associated with reuse of cardiac catheters
Rosemary E Duffy1, Braulio Couto, Jussara M Pessoa
1Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Objective:
To report the results of our preintervention investigation and subsequent 19-month three-phase intervention study designed to reduce pyrogenic reactions among patients undergoing cardiac catheterization using reprocessed catheters.
Design:
A case-control study for the preintervention period and a prospective cohort study for the intervention period.
Setting:
A 400-bed hospital in Belo Horizonte, Brazil.
Participants:
Any patient undergoing cardiac catheterization in the hospital.
Interventions:
Three intervention phases were implemented to improve the quality of the water supplied to the cardiac catheter reprocessing laboratory. Standard operating procedures for reprocessing cardiac catheters were established and reprocessing staff were trained and educated.
Results:
The rate of pyrogenic reactions decreased significantly during the intervention phases, from 12.8% (159 of 1,239) in phase 1 to 5.3% (38 of 712) in phase 2 to 0.5% (4 of 769) in phase 3 (chi-square test for linear trend, 97.5; P < .001).
Conclusion:
Improving water quality and using standard operating procedures for reprocessing catheters can prevent pyrogenic reactions in hospitalized patients.
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