Universal intravenous access cleaning device fails to sterilize stopcocks

Area of Science:

• Infection control
• Medical device decontamination
• Microbiology

Background:

• Central venous catheter (CVC) contamination poses a risk.
• Conventional open-lumen stopcock devices (COLDs) and disinfectable, needleless, closed connectors (DNCCs) are common access points.
• Pathogen inoculation of these devices can lead to catheter-associated infections.

Purpose of the Study:

• To compare the efficacy of a new universal IV access cleaning device, Site-Scrub, against 70% isopropyl alcohol prep pads.
• To evaluate the sanitization of contaminated COLDs and DNCCs using common CVC pathogens.
• To determine the effectiveness of different decontamination methods for various contamination scenarios.

Main Methods:

• Site-Scrub and alcohol prep pads were used to sanitize contaminated COLDs and DNCCs.
• Devices were filled with sterile saline or propofol and inoculated with Staphylococcus epidermidis or Pseudomonas aeruginosa.
• Contamination was introduced via glove touch or syringe tip, with colony-forming units (CFU) assessed after 24 hours.

Main Results:

• Site-Scrub showed limited efficacy on inner surface contamination of COLDs, allowing CFU growth, unlike alcohol pads.
• Alcohol pads were more effective than Site-Scrub when the rim of COLDs was contaminated.
• Both Site-Scrub and alcohol pads effectively reduced CFU growth in DNCCs, regardless of fill solution.

Conclusions:

• Current conventional open-lumen stopcock devices (COLDs) present challenges for effective decontamination.
• Disinfectable, needleless, closed connectors (DNCCs) demonstrate superior decontamination outcomes with both tested methods.
• Further research into improved IV access systems is warranted to enhance CVC safety.