title: Microbiologic contamination and time efficiency of use of automatic MDCT injectors with prefilled syringes: Results of a clinical investigation.
abstract: OBJECTIVE
  Multiple use of syringes in automatic injectors is considered to place patients at risk of septic complications. The purpose of this study was to evaluate the microbiologic contamination and time efficiency associated with routine clinical use of single-use prefilled disposable syringes for contrast administration.
  
  
  METHODS
  To ensure a hygienic background, imprints of devices and the palms of the hands of staff members were microbiologically analyzed before the clinical investigation. The microbiologic contamination of prefilled contrast and saline syringes was analyzed according to two protocols: single use of prefilled contrast syringes and saline syringes (n = 60) and single use of prefilled contrast syringes but multiple use of saline syringes for four injections or patients (n = 60). The time required for assembly of the injection system and filling and refilling for each protocol was measured.
  
  
  RESULTS
  Contamination of the surfaces of devices and palms in the CT department was within the acceptable range for hygienic conditions. Prefilled disposable syringes for the contrast agent and saline solution used once had no microbiologic contamination. Microbial contamination with coagulase-negative staphylococci was found in two saline syringes used repeatedly. The time for assembly of the injection system and installation of prefilled syringes did not differ significantly (p = 0.45) between the single-use protocol (2.3 +/- 1.1 minutes) and the multiple-use protocol (2.0 +/- 1.4 minutes).
  
  
  CONCLUSIONS
  Use of prefilled contrast syringes with single-use saline syringes is associated with time-efficient assembly of injection systems and prevents microbiologic contamination in clinical routine, especially in the care of immunocompromised patients.
authors.affiliation: Department of Clinical Radiology, University of Muenster, Germany. buerkeb@uni-muenster.de
authors.forename: Boris
authors.initials: B
authors.lastname: Buerke
authors.forename: Michael
authors.initials: M
authors.lastname: Puesken
authors.forename: Alexander
authors.initials: A
authors.lastname: Mellmann
authors.forename: Harald
authors.initials: H
authors.lastname: Seifarth
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
authors.forename: Johannes
authors.initials: J
authors.lastname: Wessling
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D003287:Contrast Media / Q000008:administration & dosage; D004526:Efficiency; D004866:Equipment Contamination; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006225:Hand / Q000382:microbiology; D006801:Humans; D017053:Infection Control / Q000592:standards*; D007267:Injections / Q000295:instrumentation; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013594:Syringes / Q000382:microbiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide