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Published on: July 13, 2019
An in vitro comparison of microbial ingress into 8 different needleless IV access devices
Anna Casey1, Tarja Karpanen, Peter Nightingale
1University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. Anna Casey, PhD, BSc, is affiliated with the Department of Clinical Microbiology, University Hospitals Birmingham NHS Foundation Trust in Birmingham, United Kingdom, and has 13 years of experience in clinical research. She holds a PhD in the prevention and diagnosis of central venous catheter-related infection. Tarja Karpanen, PhD, BSc, RGN, has 15 years of experience as a nurse, mainly in critical care, and more than 8 years' experience in research. She holds a PhD in the improvement of skin antisepsis. Dr. Karpanen works in the Department of Clinical Microbiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. Peter Nightingale, PhD, BSc, is a statistician who has worked in health care for 25 years. He is affiliated with the Wolfson Computer Laboratory, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. Tom Elliott, PhD, DSc, MRCP, BM, BS, BMedSci, FRCPath, has been a consultant microbiologist for 28 years and has served on many national and international advisory boards and expert groups. His main area of interest is the prevention and management of prosthetic device infections. Dr. Elliott is affiliated with the Department of Clinical Microbiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Abstract:
There are conflicting reports of the effect needleless intravenous access devices have on rates of catheter-related bloodstream infection. The aim of this study was to identify any differences between the rates of microbial ingress into 8 different devices following contamination. Each type of device was subjected to a 7-day clinical simulation that involved repeated microbial contamination of the injection site and decontamination followed by saline flushes. Significant differences in the number of microorganisms associated with each device were detected in the saline eluates. Three positive-displacement mechanical valves were associated with the ingress of significantly fewer microorganisms compared with other devices.
Insights
Needleless intravenous access devices show varied effects on bloodstream infections. This study found three positive-displacement mechanical valves significantly reduced microbial ingress compared to other devices.
Area of Science:
- Medical Devices
- Infection Control
- Microbiology
Background:
- Conflicting reports exist regarding the impact of needleless intravenous access devices (NIADs) on catheter-related bloodstream infection (CRBSI) rates.
- Understanding device-specific microbial ingress is crucial for preventing healthcare-associated infections.
Purpose of the Study:
- To compare microbial ingress rates among eight different needleless intravenous access devices.
- To identify specific device designs that may minimize bacterial contamination.
Main Methods:
- A 7-day in vitro clinical simulation was employed.
- Devices were subjected to repeated microbial contamination at the injection site.
- Decontamination protocols and saline flushes were performed to assess microbial presence.
Main Results:
- Significant differences in the number of microorganisms recovered from saline eluates were observed across the eight devices.
- Three specific positive-displacement mechanical valve devices demonstrated significantly lower microbial ingress compared to other tested devices.
Conclusions:
- Device design plays a critical role in preventing microbial contamination in needleless intravenous access systems.
- Positive-displacement mechanical valves show promise in reducing the risk of microbial ingress, potentially lowering CRBSI rates.
