Hutchens M P, Drennan S L, Cambronne E D
Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA.
Department of Molecular Microbiology & Immunology, Oregon Health & Science University, Portland, OR, USA.
J Appl Microbiol. 2015 Jun;118(6):1298-305. doi: 10.1111/jam.12802. Epub 2015 Apr 15.
Needleless connectors may develop bacterial contamination and cause central-line-associated bloodstream infections (CLABSI) despite rigorous application of best-practice. Ultraviolet (UV) light-emitting diodes (LED) are an emerging, increasingly affordable disinfection technology. We tested the hypothesis that a low-power UV LED could reliably eliminate bacteria on needleless central-line ports in a laboratory model of central-line contamination.
Needleless central-line connectors were inoculated with Staphylococcus aureus. A 285 nm UV LED was used in calibrated fashion to expose contaminated connectors. Ports were directly applied to agar plates and flushed with sterile saline, allowing assessment of bacterial survival on the port surface and in simulated usage flow-through fluid. UV applied to needleless central-line connectors was highly lethal at 0·5 cm distance at all tested exposure times. At distances >1·5 cm both simulated flow-through and port surface cultures demonstrated significant bacterial growth following UV exposure. Logarithmic-phase S. aureus subcultures were highly susceptible to UV induction/maintenance dosing.
Low-power UV LED doses at fixed time and distance from needleless central-line connector ports reduced cultivable S. aureus from >10(6) CFU to below detectable levels in this laboratory simulation of central-line port contamination.
Low-power UV LEDs may represent a feasible alternative to current best-practice in connector decontamination.
尽管严格遵循最佳实践,但无针连接器仍可能出现细菌污染并导致中心静脉导管相关血流感染(CLABSI)。紫外线(UV)发光二极管(LED)是一种新兴的、成本越来越低的消毒技术。我们在中心静脉导管污染的实验室模型中测试了低功率UV LED能否可靠地消除无针中心静脉导管端口上细菌的假设。
将金黄色葡萄球菌接种到无针中心静脉导管连接器上。使用285 nm的UV LED以校准方式照射受污染的连接器。将端口直接接种到琼脂平板上,并用无菌盐水冲洗,从而评估端口表面和模拟使用的流通液中的细菌存活情况。在所有测试的暴露时间下,在距离为0·5 cm处,施加于无针中心静脉导管连接器的紫外线具有高度致死性。在距离>1·5 cm处,紫外线照射后,模拟流通液和端口表面培养物均显示出显著的细菌生长。对数期金黄色葡萄球菌传代培养物对紫外线诱导/维持剂量高度敏感。
在这个中心静脉导管端口污染的实验室模拟中,在固定时间和距离无针中心静脉导管连接器端口处给予低功率UV LED剂量,可将可培养的金黄色葡萄球菌从>10(6) CFU减少到检测水平以下。
低功率UV LED可能是目前连接器去污最佳实践的一种可行替代方法。