Continuous passive disinfection of catheter hubs prevents contamination and bloodstream infection.
BACKGROUND
Catheter hub decontamination requires a thorough scrub and compliance varies. This study evaluates the effectiveness of a disinfection cap with 70% alcohol in preventing contamination/infection.


METHODS
A 3-phased, multifacility, quasi-experimental study of adult patients with central lines divided into P1 (baseline), when the standard scrub was used; P2, when the cap was used on all central lines; and P3, when standard disinfection was reinstituted. House-wide central-line associated bloodstream infection (CLABSI) rates are reported with catheter-associated urinary tract infections (CAUTI) as a control measure. Adults with peripherally inserted central catheters inserted during hospitalization having 5+ consecutive line-days gave consent and were enrolled, and 1.5 mL of blood was withdrawn from each lumen not in use and quantitatively cultured.


RESULTS
Contamination was 12.7% (32/252) during P1; 5.5% (20/364) in P2 (P = .002), and 12.0% (22/183; P = 0.88 vs P1 and P = .01 vs P2) in P3 (P = .001 vs P2). The median colony-forming units per milliliter was 4 for P1, 1 for P2 (P = .009), and 2 for P3 (P = .05 vs P2). CLABSI rates declined from 1.43 per 1,000 line-days (16/11,154) to 0.69 (13/18,972) in P2 (P = .04) and increased to 1.31 (7/5,354) in P3. CAUTI rates remained stable between P1 and P2 (1.42 and 1.41, respectively, P = .90) but declined in P3 (1.04, P = .03 vs P1 and P2).


CONCLUSIONS
Disinfecting caps reduce line contamination, organism density, and CLABSIs.
Department of Infection Control, NorthShore University HealthSystem, Evanston, IL 60201, USA. mwright@northshore.org
Marc-Oliver
MO
Wright
Jackie
J
Tropp
Donna M
DM
Schora
Mary
M
Dillon-Grant
Kari
K
Peterson
Sue
S
Boehm
Ari
A
Robicsek
Lance R
LR
Peterson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D057785:Catheters / Q000382:microbiology*; D015169:Colony Count, Microbial; D004202:Disinfectants / Q000008:administration & dosage*; D004203:Disinfection / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000517:prevention & control*
D004202:Disinfectants