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Adequate Disinfection of a Split-Septum Needleless Intravascular Connector with a 5-Second Alcohol Scrub

  • Mark E. Rupp (a1) (a2), Stephanie Yu (a1), Tomas Huerta (a1), R. Jennifer Cavalieri (a1), Roxanne Alter (a3), Paul D. Fey (a3), Trevor Van Schooneveld (a1) (a2) and James R. Anderson (a4)...

Abstract

Objective.

Define optimum vascular catheter connector valve disinfection practices under laboratory and clinical conditions.

Design.

Prospective observational clinical survey and laboratory assessment of disinfection procedures.

Setting.

All adult inpatients at an academic healthcare center.

Methods.

In the clinical setting, contamination of needleless connectors was assessed in 6 weekly prevalence surveys in which the connector valves from central venous catheters (CVCs) in situ were cultured by pressing the connector diaphragm to an agar plate. Before culture, valves were disinfected by scrubbing the diaphragm with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds. In the laboratory, the diaphragms on 150 unused sterile connector valves were inoculated with 103, 105, or 108 colony-forming units of Staphylococcus epidermidis and allowed to dry. After disinfection of the diaphragms by scrubbing with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds, the valves were sampled by pressing the diaphragm to an agar plate.

Results.

In the clinical setting, 363 connector valves from patients with CVCs were sampled, and 66.7% of nondisinfected valves revealed bacterial contamination. After 5-second disinfection with an alcohol pledget, only 1 (1.4%) of 71 yielded microbial growth (P < .005). In the laboratory, at the 103 and 105 inoculum, all connector valves yielded sterile cultures when scrubbed for 5 or more seconds (P < .001). At the 108 inoculum, 2 (20%) of 10 connector valves yielded minimal growth of S. epidermidis.

Conclusions.

A 5-second scrub with a 70% isopropyl alcohol pledget yields adequate disinfection of a split-septum intravascular catheter connector valve under clinical and laboratory conditions.

Copyright

Corresponding author

984031 Nebraska Medical Center, Omaha, NE 68198 (merupp@unmc.edu)

References

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