Adequate disinfection of a split-septum needleless intravascular connector with a 5-second alcohol scrub.
OBJECTIVE
Define optimum vascular catheter connector valve disinfection practices under laboratory and clinical conditions.


METHODS
Prospective observational clinical survey and laboratory assessment of disinfection procedures.


METHODS
All adult inpatients at an academic healthcare center.


METHODS
In the clinical setting, contamination of needleless connectors was assessed in 6 weekly prevalence surveys in which the connector valves from central venous catheters (CVCs) in situ were cultured by pressing the connector diaphragm to an agar plate. Before culture, valves were disinfected by scrubbing the diaphragm with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds. In the laboratory, the diaphragms on 150 unused sterile connector valves were inoculated with 10(3), 10(5), or 10(8) colony-forming units of Staphylococcus epidermidis and allowed to dry. After disinfection of the diaphragms by scrubbing with a 70% isopropyl alcohol pledget for 0, 5, 10, 15, or 30 seconds, the valves were sampled by pressing the diaphragm to an agar plate.


RESULTS
In the clinical setting, 363 connector valves from patients with CVCs were sampled, and 66.7% of nondisinfected valves revealed bacterial contamination. After 5-second disinfection with an alcohol pledget, only 1 (1.4%) of 71 yielded microbial growth (P < .005). In the laboratory, at the 10(3) and 10(5) inoculum, all connector valves yielded sterile cultures when scrubbed for 5 or more seconds (P < .001). At the 10(8) inoculum, 2 (20%) of 10 connector valves yielded minimal growth of S. epidermidis.


CONCLUSIONS
A 5-second scrub with a 70% isopropyl alcohol pledget yields adequate disinfection of a split-septum intravascular catheter connector valve under clinical and laboratory conditions.
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA. merupp@unmc.edu
Mark E
ME
Rupp
Stephanie
S
Yu
Tomas
T
Huerta
R Jennifer
RJ
Cavalieri
Roxanne
R
Alter
Paul D
PD
Fey
Trevor
T
Van Schooneveld
James R
JR
Anderson
D003428:Cross Infection / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods*; D004202:Disinfectants / Q000008:administration & dosage*; D019723:Endoscopes / Q000382:microbiology*; D004866:Equipment Contamination; D000431:Ethanol / Q000008:administration & dosage*; D006801:Humans; D014481:United States
D004202:Disinfectants; D000431:Ethanol