title: Novel approach to investigate a source of microbial contamination of central venous catheters.
abstract: The potential route of contamination by skin microorganisms onto the distal tip of central venous catheters during insertion was investigated. Thirty patients undergoing cardiac surgery who required a central venous catheter (CVC) as part of their clinical management were studied. Following catheter placement, the device insertion equipment and the skin at the insertion site were sampled for microorganisms. The distal tips of the CVCs were also sampled in situ within 90 min post insertion. Bacteria were isolated from 20 of 30 (66%) CVC skin insertion sites, from 15 of 30 (50%) guidewires, and from five of 30 (16%) catheter distal tips in situ. These findings suggest that despite rigorous skin disinfection and strict aseptic technique, viable microorganisms are impacted during insertion onto the distal tip of the CVC, which may act as a subsequent nidus of infection.
authors.affiliation: Department of Clinical Microbiology, University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Edgbaston, UK.
authors.forename: T S
authors.initials: TS
authors.lastname: Elliott
authors.forename: H A
authors.initials: HA
authors.lastname: Moss
authors.forename: S E
authors.initials: SE
authors.lastname: Tebbs
authors.forename: I C
authors.initials: IC
authors.lastname: Wilson
authors.forename: R S
authors.initials: RS
authors.lastname: Bonser
authors.forename: T R
authors.initials: TR
authors.lastname: Graham
authors.forename: L P
authors.initials: LP
authors.lastname: Burke
authors.forename: M H
authors.initials: MH
authors.lastname: Faroqui
mesh_terms: D000328:Adult; D000368:Aged; D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000209:etiology*; D006348:Cardiac Surgical Procedures; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003354:Corynebacterium Infections / Q000175:diagnosis; D016983:Enterococcus / Q000302:isolation & purification; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000175:diagnosis; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis