Optimal disinfection times for needleless IV connectors to decrease rates of bacterial migration

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Intravenous literature: Smith, J.S., Irwin, G., Viney, M., Watkins, L., Morris, S.P., Kirksey, K.M. and Brown, A. (2012) Optimal Disinfection Times for Needleless Intravenous Connectors. The Journal of the Association for Vascular Access. 17(3), p.137-143.

Abstract:

Background – Elimination of catheter-related bloodstream infections is a major focus in health care. According to the Centers for Disease Control and Prevention and the Infusion Nurses Society, the optimal time for needleless connector disinfection has not yet been empirically established.

Methods – Using experimental design and established lab procedure, a 0.5 MacFarland suspension was used to inoculate 172 needleless connectors with bacteria (Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa) and allowed to dry for 18 hours. Five groups of connectors (n = 27 per group) were disinfected using 70% isopropyl alcohol with friction for 5, 8, 10, 12, and 15 seconds, and flushed with 0.5 mL nonbacteriostatic sterile normal saline onto sheep-blood agar plates for incubation at 35°C for 48 hours. Bacterial growth (1 colony) was noted on 2 negative controls; therefore, a second sample (n = 172) was tested as above using additional precautions of masking, gloving, and gowning. A third group of connectors was tested using a 0.5 MacFarland suspension containing yeast (Candida albicans).

Results – Group 1 showed significant (?24 = 37.93; P = .00) and strong (Cramér’s V = 0.53; P = .00) associations between scrub time and growth status. Although not statistically significant, Groups 2 and 3 demonstrated clinically significant associations between these factors.

Conclusions – Although additional research is warranted, our study showed that disinfection times of 5 and 8 seconds were inadequate for reducing bacterial transfer. However, disinfection times of 10, 12, and 15 seconds resulted in comparable, decreased rates of bacterial migration.

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