Fillman Kelsey M, Ryder Jonathan H, Brailita Daniel M, Rupp Mark E, Cavalieri R Jennifer, Fey Paul D, Lyden Elizabeth R, Hankins Richard J
University of Nebraska Medical Center, Omaha, Nebraska.
Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska.
Infect Control Hosp Epidemiol. 2024 Jan;45(1):35-39. doi: 10.1017/ice.2023.148. Epub 2023 Jul 19.
Determination of whether vascular catheter disinfecting antiseptic-containing caps alone are effective at decreasing microbial colonization of connectors compared to antiseptic-containing caps plus a 5-second alcohol manual disinfection.
The study was conducted in a 718-bed, tertiary-care, academic hospital.
A convenience sample of adult patients across intensive care units and acute care wards with peripheral and central venous catheters covered with antiseptic-containing caps.
Quality improvement study completed over 5 days. The standard-of-care group consisted of catheter connectors with antiseptic-containing caps cleaned with a 5-second alcohol wipe scrub prior to culture. The comparison group consisted of catheter connectors with antiseptic-containing caps without a 5-second alcohol wipe scrub prior to culture. The connectors were pressed directly onto blood agar plates and incubated. Plates were assessed for growth after 48-72 hours.
In total, 356 catheter connectors were cultured: 165 in the standard-of-care group, 165 in the comparison group, and 26 catheters connectors without an antiseptic-containing cap, which were designated as controls. Overall, 18 catheter connectors (5.06%) yielded microbial growth. Of the 18 connectors with microbial growth, 2 (1.21%) were from the comparison group, 1 (0.61%) was from the standard-of-care group, and 15 were controls without an antiseptic-containing cap.
Bacterial colonization rates were similar between the catheter connectors cultured with antiseptic-containing caps alone and catheter connectors with antiseptic-containing caps cultured after a 5-second scrub with alcohol. This finding suggests that the use of antiseptic-containing caps precludes the need for additional disinfection.
确定仅使用含血管导管消毒防腐剂的帽盖与使用含防腐剂帽盖并辅以5秒酒精手动消毒相比,在减少连接器微生物定植方面是否有效。
该研究在一家拥有718张床位的三级护理学术医院进行。
选取入住重症监护病房和急性护理病房的成年患者作为便利样本,这些患者的外周和中心静脉导管均覆盖有含防腐剂的帽盖。
在5天内完成的质量改进研究。标准护理组由在培养前用酒精擦拭5秒进行清洁的、带有含防腐剂帽盖的导管连接器组成。对照组由在培养前未进行5秒酒精擦拭的、带有含防腐剂帽盖的导管连接器组成。将连接器直接按压在血琼脂平板上并进行培养。48 - 72小时后评估平板上的生长情况。
总共对356个导管连接器进行了培养:标准护理组165个,对照组165个,另外26个没有含防腐剂帽盖的导管连接器作为对照。总体而言,18个导管连接器(5.06%)出现微生物生长。在这18个有微生物生长的连接器中,2个(1.21%)来自对照组,1个(0.61%)来自标准护理组,15个是没有含防腐剂帽盖的对照。
仅使用含防腐剂帽盖培养的导管连接器与使用含防腐剂帽盖并经酒精擦拭5秒后培养的导管连接器的细菌定植率相似。这一发现表明,使用含防腐剂的帽盖无需额外消毒。