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The potential reduction of microbial contamination of central venous catheters
S E Tebbs1, V Trend, T S Elliott
1Department of Clinical Microbiology, Queen Elizabeth Hospital, Edgbaston, Birmingham, U.K.
Abstract:
The microbial contamination of stopcock entry ports attached to central venous catheters (CVC) was determined using a specially designed swab. The swab was made of a highly porous material, Porex, and was designed to fit exactly into the entry port of stopcocks. The swab was used to determine the frequency of microbial contamination of entry ports attached to CVC in patients located on an Intensive Care Unit. Of the 200 swabs obtained 44 (22%) contained microorganisms. Coagulase-negative staphylococci were recovered from 43 of the swabs and diphtheroid bacilli from 1 swab. In vitro studies were carried out to investigate the efficiency of the swab in removing excess residual fluid and organisms from entry ports. The swab absorbed relatively large numbers of bacteria within seconds. When entry ports were inoculated with between 10(3) and 10(5) cfu of either Staphylococcus epidermidis or Klebsiella pneumoniae greater than 99% of the organisms were absorbed by the swab (P < 0.01). The absorbent swab was more efficient at removing S. epidermidis from the entry port when compared to a standard cotton swab (P < 0.01). In vitro this absorbent swab reduced the potential for catheter contamination resulting from migration of organisms from the entry port via the intraluminal route. The use of the swab in the clinical situation may reduce the incidence of CVC-related infections.
Insights
A novel absorbent swab effectively reduces microbial contamination on central venous catheter (CVC) stopcock ports. This innovation shows promise in preventing CVC-related infections by absorbing bacteria from entry ports.
Area of Science:
- Microbiology
- Infection Control
- Medical Devices
Background:
- Central venous catheters (CVCs) are crucial in intensive care but pose infection risks.
- Stopcock entry ports are potential sites for microbial contamination.
- Preventing contamination is vital to reduce CVC-related bloodstream infections.
Purpose of the Study:
- To evaluate the microbial contamination frequency on CVC stopcock entry ports.
- To assess the efficacy of a novel absorbent swab in removing microorganisms from these ports.
- To determine the potential of the swab in reducing CVC-related infections.
Main Methods:
- A specially designed absorbent swab made of Porex material was used.
- Swabs were collected from 200 CVC stopcock entry ports in an Intensive Care Unit.
- In vitro studies quantified bacterial absorption efficiency against Staphylococcus epidermidis and Klebsiella pneumoniae.
Main Results:
- Microbial contamination was detected in 22% (44/200) of the CVC stopcock entry ports.
- Coagulase-negative staphylococci were the predominant microorganisms found.
- The absorbent swab demonstrated high efficiency, removing >99% of inoculated bacteria in vitro, outperforming standard cotton swabs.
Conclusions:
- The novel absorbent swab effectively removes microorganisms from CVC stopcock entry ports.
- This absorbent swab has the potential to decrease microbial load and reduce the incidence of CVC-related infections.
- Further clinical use of this swab may enhance patient safety in intensive care settings.