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Published on: July 13, 2019
Microbiological comparison of a silver-coated and a non-coated needleless intravascular connector in clinical use
A L Casey1, T J Karpanen, P Nightingale
1University Hospitals Birmingham NHS Foundation Trust, The Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Background:
The potential for microbial contamination of needleless intravascular (IV) connectors and the risk of subsequent infection are currently a subject of debate.
Aim:
To compare the number of micro-organisms associated with silver-coated and non-coated connectors in a clinical setting.
Methods:
Twenty-five patients with haematological malignancies who required a central venous catheter (CVC) as part of their clinical management were studied. Each patient's CVC was randomly designated to have attached either silver-coated or non-coated connectors. Before and after each manipulation of the connectors, the compression seals were decontaminated with a wipe incorporating 2% (w/v) chlorhexidine gluconate in 70% (v/v) isopropyl alcohol. Following four days in situ, the number of micro-organisms recovered from 119 silver-coated and 117 non-coated connectors was determined.
Findings:
Thirty-six (30.3%) silver-coated connectors had micro-organisms present on the external silicone compression seal compared to 41 (35%) non-coated connectors [odds ratio (OR): 0.8; 95% confidence interval (CI): 0.47-1.39; P = 0.49]. Conversely, the internal fluid pathway of 31 (26.1%) silver-coated connectors had micro-organisms present compared to 55 (47.0%) of the non-coated connectors (OR: 0.40; 95% CI: 0.23-0.69; P = 0.001). In addition, the total number of micro-organisms present was less in the silver-coated connectors as compared to non-coated devices (P = 0.001).
Conclusion:
The use of a silver-coated connector with a dedicated decontamination regime may reduce the risk of catheter-related bloodstream infection acquired via the intraluminal route.
Insights
Silver-coated intravascular (IV) connectors significantly reduced microbial contamination within the internal fluid pathway compared to non-coated devices. This finding suggests a potential to lower catheter-related bloodstream infections with silver-coated IV connectors.
Area of Science:
- Medical Microbiology
- Infectious Disease Prevention
- Biomedical Engineering
Background:
- Microbial contamination of needleless intravascular (IV) connectors is a debated risk factor for healthcare-associated infections.
- Understanding contamination pathways is crucial for developing effective infection control strategies.
Purpose of the Study:
- To quantitatively compare microbial colonization on silver-coated versus non-coated intravascular connectors in a clinical setting.
- To assess the impact of silver-coating on microbial presence in both external and internal components of IV connectors.
Main Methods:
- A randomized study involving 25 patients with hematological malignancies requiring central venous catheters (CVCs).
- CVCs were fitted with either silver-coated or non-coated connectors, with standardized decontamination protocols.
- Microbial analysis of 119 silver-coated and 117 non-coated connectors after four days of use.
Main Results:
- While external contamination showed no significant difference, silver-coated connectors had significantly fewer microorganisms in the internal fluid pathway (26.1% vs. 47.0%, P=0.001).
- The overall microbial load was substantially lower in silver-coated connectors compared to non-coated ones (P=0.001).
Conclusions:
- Silver-coated intravascular connectors, when used with proper decontamination, demonstrate a significant reduction in intraluminal microbial contamination.
- This suggests a promising strategy for mitigating the risk of catheter-related bloodstream infections acquired through the intraluminal route.
