Guembe M, Pérez-Granda M J, Cruces R, Alcalá L, Bouza E
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, C/. Dr. Esquerdo, 46, 28007, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain.
Eur J Clin Microbiol Infect Dis. 2016 Aug;35(8):1341-5. doi: 10.1007/s10096-016-2670-4. Epub 2016 May 17.
Catheter connectors used in hemodialysis patients are those with open caps to manage high blood flows. However, current guidelines for the prevention of catheter infections recommend closed connectors. Tego™ is a closed connector designed to enable high blood flows. We used an in vitro model to compare the efficacy of Tego™ against contamination with that of standard caps in a real-life practice scenario. The model consisted of 200 blood culture bottles (BCB) with an inserted cannula closed either with Tego™ (100) or with open caps (100). BCB were manipulated using two different methods: under aseptic conditions and with gloves contaminated with a 0.05 McFarland Staphylococcus aureus solution. The BCB were incubated at 37 °C under continuous shaking for up to 7 days or until positive. When a BCB turned positive, 100 μL of the fluid was cultured. The positivity rate and time to positivity of the BCB in each method were compared. Overall, 4.0 % of BCB with Tego™ and 52.0 % of BCB with open caps were positive in the sterile model (p < 0.001), whereas all BCB in the contamination model were positive. We did not find differences regarding the median time (hours) to positivity between Tego™ and the standard cap in the contamination model (19.04 vs. 17.87, p = 0.465). In our model, Tego™ proved to be better than the standard cap for the prevention of contamination when the device was handled under optimal conditions. Moreover, it was as efficient as the standard catheter cap in the contamination model.
用于血液透析患者的导管接头是带有开口帽以处理高血流量的那种。然而,当前预防导管感染的指南推荐使用封闭接头。Tego™是一种设计用于实现高血流量的封闭接头。我们使用体外模型在实际操作场景中比较了Tego™与标准帽防止污染的效果。该模型由200个血培养瓶(BCB)组成,每个瓶中插入一根插管,插管分别用Tego™(100个)或开口帽(100个)封闭。BCB采用两种不同方法进行操作:在无菌条件下以及用含有0.05麦氏浓度金黄色葡萄球菌溶液污染的手套操作。将BCB在37°C下持续振荡培养长达7天或直至呈阳性。当BCB变为阳性时,取100μL液体进行培养。比较了每种方法中BCB的阳性率和达到阳性的时间。总体而言,在无菌模型中,使用Tego™的BCB有4.0%呈阳性,使用开口帽的BCB有52.0%呈阳性(p<0.001),而在污染模型中所有BCB均呈阳性。在污染模型中,我们未发现Tego™与标准帽之间达到阳性的中位时间(小时)有差异(19.04对17.87,p = 0.465)。在我们的模型中,当在最佳条件下操作设备时,Tego™在预防污染方面被证明优于标准帽。此外,在污染模型中它与标准导管帽的效率相同。