İzmir Katip Çelebi University, Faculty of Health Sciences, Department of Nursing, Izmir, Turkey.
İzmir Katip Çelebi University, Faculty of Medicine, Department of Medical Microbiology, Izmir, Turkey.
Intensive Crit Care Nurs. 2023 Aug;77:103414. doi: 10.1016/j.iccn.2023.103414. Epub 2023 Feb 18.
The aim of this study was to determine bacterial contamination of needleless connectors before and after disinfection to assess the risk for the point of catheter-related bloodstream infections.
RESEARCH METHODOLOGY/DESIGN: Experimental study design.
The research was carried out on patients with a central venous catheter hospitalized in the intensive care unit.
Bacterial contamination of needleless connectors integrated into central venous catheters was assessed before and after disinfection. Antimicrobial susceptibilities of colonized isolates were investigated. In addition, the compatibility of the isolates with the bacteriological cultures of the patients was determined over a one-month period.
Bacterial contamination varied between 5×10 and 1×10 colony forming unit was detected before disinfection in 91.7% of needleless connectors. Most common bacteria were coagulase-negative staphylococci; others were Staphylococcus aureus, Enterococcus faecalis, and Corynebacterium species. While most isolates were resistant to penicillin, trimethoprim-sulfamethoxazole, cefoxitin, and linezolid, each was susceptible to vancomycin or teicoplanin. Bacterial survival was not detected on needleless connectors after disinfection. There was no compatibility between the one-month bacteriological culture results of the patients and the bacteria isolated from the needleless connectors.
Bacterial contamination was detected on the needleless connectors before disinfection, although they were not rich in bacterial diversity. There was no bacterial growth after disinfection with an alcohol-impregnated swab.
The majority of needleless connectors had bacterial contamination before disinfection. Needleless connectors should be disinfected for 30 seconds before use, particularly in immunocompromised patients. However, the use of needleless connectors with antiseptic barrier caps may be a more practical and effective solution instead.
本研究旨在确定消毒前后无针接头的细菌污染情况，以评估与导管相关血流感染相关的导管尖端的感染风险。
研究方法/设计：实验研究设计。
研究对象为入住重症监护病房的中心静脉导管患者。
评估消毒前后无针接头内的中央静脉导管细菌污染情况。对定植分离株的抗菌药敏性进行调查。此外，在一个月的时间内，确定分离株与患者的细菌培养物的相容性。
在消毒前，91.7%的无针接头中检测到细菌污染，范围为 5×10 至 1×10 菌落形成单位。最常见的细菌是凝固酶阴性葡萄球菌，其他还有金黄色葡萄球菌、粪肠球菌和棒状杆菌属。虽然大多数分离株对青霉素、甲氧苄啶-磺胺甲恶唑、头孢西丁和利奈唑胺耐药，但对万古霉素或替考拉宁均敏感。消毒后，无针接头上未检测到细菌存活。患者一个月的细菌培养结果与从无针接头上分离的细菌之间没有相关性。
尽管无针接头的细菌多样性不丰富，但在消毒前已检测到细菌污染。用酒精浸渍拭子消毒后，无细菌生长。
大多数无针接头在消毒前都有细菌污染。在使用前，应将无针接头消毒 30 秒，特别是在免疫功能低下的患者中。然而，使用带有抗菌屏障帽的无针接头可能是一种更实用、更有效的解决方案。
