Evaluating the efficacy of disinfectant agents and application times for vascular catheter needleless connector decontamination.

BACKGROUND

Needleless connectors (NCs) are attached to vascular catheters to provide an injectable closed circuit without risk of needlestick injuries but some have been associated with catheter-associated bloodstream infections (CABSIs), which increase treatment costs and hospital stays. Effective NC disinfection before catheter use is therefore critical. This study evaluated the efficacy of three disinfectant agents across varying decontamination durations and drying times.

METHODS

NC septa were inoculated with clinically isolated Acinetobacter courvalinii and Staphylococcus hominis from venous access devices (VAD) insertion sites and infusion tubing, then treated with either 70 % isopropyl alcohol (IPA), 2 % chlorhexidine gluconate in 70 % IPA (CHG-IPA) for 5, 10, or 15 s, or alcohol-impregnated antiseptic caps (AICs) for 5 min. Treatments were followed by drying times of 5, 10, or 15 s. Bacterial recovery was assessed via vortexing and sonication in Dey-Engley neutralising broth, followed by spread-plating on Tryptic Soy Agar and incubation at 37 °C. A total of 378 decontamination procedures were performed, with nine replicates per condition.

RESULTS

All disinfectant treatments significantly reduced (p < 0.05) bacterial counts compared to positive controls, achieving reductions of approximately 2.4-4.4 log CFU/mL. However, no statistically significant differences (p > 0.05) were observed among disinfectant types, application durations, or drying times.

CONCLUSION

NC disinfection proved essential in reducing bacterial counts. While no method proved superior, the study may have been underpowered for some comparisons and larger studies should further evaluate both CHG in IPA and AICs.