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Preparation of B. Braun Easypump® II elastomeric devices with Chemfort™ closed system transfer devices (CSTDs) in
1Pharmacy Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Background:
Outpatient parenteral antimicrobial therapy (OPAT) enables patients to receive intravenous antimicrobials outside hospital settings. Elastomeric infusion devices facilitate continuous antibiotic delivery; however, limited stability data and constrained aseptic unit capacity have led some services to adopt nurse-led 'fresh-fill' preparation in uncontrolled environments, which may increase microbial contamination risk.
Objectives:
To evaluate whether preparation of B. Braun Easypump® II elastomeric devices using Chemfort™ closed system transfer devices (CSTDs) in uncontrolled environments reduces microbial contamination compared with preparation using needles and syringes.
Methods:
Forty-six elastomeric devices were prepared with tryptic soy broth by eight operators across three uncontrolled rooms using either Chemfort™ CSTDs (n = 23) or needles and syringes (n = 23). Aseptic non-touch technique was followed. Devices were incubated at 32°C for 7 days before microbiological testing. Environmental monitoring included settle plates and finger dabs. Fisher's exact test was used to analyse contamination rates.
Results:
No contamination occurred in devices prepared using CSTDs (0/23), whereas 5/23 (22%) prepared using needles were contaminated. This difference was statistically significant (P = 0.0491). Preparation times were shorter and more consistent using CSTDs (median 26 min; range 20-40) compared with needles and syringes (median 34 min; range 22-64).
Conclusions:
Preparation using Chemfort™ CSTDs was associated with reduced microbial contamination and shorter preparation times compared with needle-based methods. CSTDs may provide a useful risk-reduction strategy for nurse-prepared elastomeric infusions in OPAT services, although further evaluation in larger studies is required.
