Casey Anna L, Karpanen Tarja J, Nightingale Peter, Elliott Tom Sj
Clinical Research Scientist, University Hospitals Birmingham NHS Foundation Trust, Birmingham.
Clinical Research Nurse, University Hospitals Birmingham NHS Foundation Trust, Birmingham.
Br J Nurs. 2018 Jan 25;27(2):S18-S26. doi: 10.12968/bjon.2018.27.2.S18.
needle-free connectors are widely used in clinical practice. The aim of this study was to identify any differences between microbial ingress into six different connectors (three neutral-displacement, one negative-displacement and two anti-reflux connectors).
each connector underwent a 7-day clinical simulation involving repeated microbial contamination of the connector's injection ports with Staphylococcus aureus followed by decontamination and then saline flushes through each connector. The simulation was designed to be a surrogate marker for the potential risk of contamination in clinical practice.
increasing numbers of S. aureus were detected in the flushes over the 7 days of sampling despite adherence to a rigorous decontamination programme. Significant differences in the number of S. aureus recovered from the saline flush of some types of connectors were also detected. Two different durations (5- and 15-second) of decontamination of the injection ports with 70% isopropyl alcohol (IPA) wipes were also investigated. There was no significant difference between the median number of S. aureus recovered in the saline flushes following a 5-second (165.5, 95% CI=93-260) or a 15-second decontamination regimen (75, 10-190).
The findings suggest that there may be differences in the risk of internal microbial contamination with different types of connectors and that even 15 seconds of decontamination may not fully eradicate microorganisms from the injection ports of some devices.
无针连接器在临床实践中广泛使用。本研究的目的是确定六种不同连接器(三种中性位移、一种负位移和两种防回流连接器)微生物侵入情况之间的差异。
每个连接器都经历了为期7天的临床模拟,包括用金黄色葡萄球菌反复污染连接器的注射端口,然后进行去污,接着通过每个连接器用生理盐水冲洗。该模拟旨在作为临床实践中潜在污染风险的替代指标。
尽管严格遵守去污程序,但在7天的采样过程中,冲洗液中检测到的金黄色葡萄球菌数量不断增加。还检测到从某些类型连接器的生理盐水冲洗液中回收的金黄色葡萄球菌数量存在显著差异。还研究了用70%异丙醇(IPA)擦拭巾对注射端口进行5秒和15秒两种不同时长的去污效果。在5秒(165.5,95%可信区间=93-260)或15秒去污方案后生理盐水冲洗液中回收的金黄色葡萄球菌中位数之间没有显著差异。
研究结果表明,不同类型的连接器内部微生物污染风险可能存在差异,并且即使15秒的去污也可能无法完全清除某些设备注射端口的微生物。