title: Microbiological comparison of a silver-coated and a non-coated needleless intravascular connector in clinical use.
abstract: BACKGROUND
  The potential for microbial contamination of needleless intravascular (IV) connectors and the risk of subsequent infection are currently a subject of debate.
  
  
  OBJECTIVE
  To compare the number of micro-organisms associated with silver-coated and non-coated connectors in a clinical setting.
  
  
  METHODS
  Twenty-five patients with haematological malignancies who required a central venous catheter (CVC) as part of their clinical management were studied. Each patient's CVC was randomly designated to have attached either silver-coated or non-coated connectors. Before and after each manipulation of the connectors, the compression seals were decontaminated with a wipe incorporating 2% (w/v) chlorhexidine gluconate in 70% (v/v) isopropyl alcohol. Following four days in situ, the number of micro-organisms recovered from 119 silver-coated and 117 non-coated connectors was determined.
  
  
  RESULTS
  Thirty-six (30.3%) silver-coated connectors had micro-organisms present on the external silicone compression seal compared to 41 (35%) non-coated connectors [odds ratio (OR): 0.8; 95% confidence interval (CI): 0.47-1.39; P = 0.49]. Conversely, the internal fluid pathway of 31 (26.1%) silver-coated connectors had micro-organisms present compared to 55 (47.0%) of the non-coated connectors (OR: 0.40; 95% CI: 0.23-0.69; P = 0.001). In addition, the total number of micro-organisms present was less in the silver-coated connectors as compared to non-coated devices (P = 0.001).
  
  
  CONCLUSIONS
  The use of a silver-coated connector with a dedicated decontamination regime may reduce the risk of catheter-related bloodstream infection acquired via the intraluminal route.
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, The Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
authors.forename: A L
authors.initials: AL
authors.lastname: Casey
authors.forename: T J
authors.initials: TJ
authors.lastname: Karpanen
authors.forename: P
authors.initials: P
authors.lastname: Nightingale
authors.forename: M
authors.initials: M
authors.lastname: Cook
authors.forename: T S J
authors.initials: TS
authors.lastname: Elliott
mesh_terms: D000328:Adult; D000368:Aged; D001419:Bacteria / Q000302:isolation & purification; D055499:Catheter-Related Infections / Q000517:prevention & control; D002408:Catheters, Indwelling / Q000382:microbiology*; D020099:Coated Materials, Biocompatible; D015169:Colony Count, Microbial; D004202:Disinfectants / Q000494:pharmacology*; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012834:Silver / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D020099:Coated Materials, Biocompatible; D004202:Disinfectants; D012834:Silver