title: Efficacy of three different valve systems of needle-free closed connectors in avoiding access of microorganisms to endovascular catheters after incorrect handling.
abstract: OBJECTIVE
  Disinfectable needle-free closed connectors were designed to avoid needle-stick injuries and to be easily disinfected before handling. Workloads or lack of knowledge, however, could impede the correct handling of these devices, allowing endoluminal catheter colonization. The aim of our study was to assess the barrier effect of different disinfectable needle-free closed connectors during correct and incorrect handling using an experimental model.
  
  
  METHODS
  We used a model consisting of a blood culture bottle with a peripheral venous catheter inserted under sterile conditions. Three different disinfectable needle-free closed connectors with different valve designs (microClave, Bionector, and Smartsite plus) were used to close the catheters. The external surfaces of the disinfectable needle-free closed connectors were contaminated with different concentrations of a Staphylococcus epidermidis culture broth. After contamination, 10 units of each connector and each concentration were assigned to the correct handling group (cleaned with 70% ethylic alcohol before handling) and the same number to the incorrect handling group (handled without disinfection) with a total of 180 bottles.
  
  
  RESULTS
  Increases in concentrations of external contamination and incorrect handling of the connectors resulted in an increase in connectors' permeability to the pass of microorganisms to the endoluminal way. MicroClave proved the best barrier in the experimental conditions described.
  
  
  CONCLUSIONS
  The barrier effect of disinfectable needle-free closed connectors is adversely affected by incorrect handling, the quantity of external valve colonization, and the valve design.
authors.affiliation: Intensive Care Department, Hospital de Mataró, Barcelona, Spain. jyebenes@csdm.es
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Yébenes
authors.forename: Maria
authors.initials: M
authors.lastname: Delgado
authors.forename: Goretti
authors.initials: G
authors.lastname: Sauca
authors.forename: Mateu
authors.initials: M
authors.lastname: Serra-Prat
authors.forename: Manel
authors.initials: M
authors.lastname: Solsona
authors.forename: Jordi
authors.initials: J
authors.lastname: Almirall
authors.forename: Josep Antón
authors.initials: JA
authors.lastname: Capdevila
authors.forename: Xavier
authors.initials: X
authors.lastname: Balanzó
mesh_terms: D002406:Catheterization, Peripheral / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000382:microbiology*; D004866:Equipment Contamination / Q000517:prevention & control*; D004867:Equipment Design; D013212:Staphylococcus epidermidis