414. Microbial Colonization of an Intravascular Catheter Connector in Hospitalized Patients with Active Intravenous Infusions
Session: Poster Abstract Session: HAI: Preventing Device-Associated Infections
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • powerpoint files IDWeek poster_microb_2_PDF.pdf (402.7 kB)
  • Background: Central Line Associated Bloodstream Infections (CLABSI) are primarily due to extraluminal carriage of skin flora into the bloodstream via the catheter, however, colonization of catheter hubs and infusate are also potential causes of CLABSI.  We previously demonstrated that the split septum IV connector (Lever Lock, Becton Dickinson) is readily disinfected with a 5 second alcohol scrub, however, the unenclosed design of the connector may allow for bacterial contamination during use thereby potentially increasing the risk for CLABSI. We sought to determine the rate of colonization of this system.

    Methods:A prospective study was performed over 3 consecutive days in hospitalized adult patients receiving an active infusion. Critical infusions and antibiotics were excluded. The hubs were inoculated onto blood agar plates which were subsequently incubated and assessed for microbial growth after 48-72 hours.

    Results: 234 catheter hubs were cultured. 85 catheters were internal jugular venous lines, 57 were peripherally inserted central catheters, 52 were peripheral intravenous catheters, 33 were central catheters inserted at alternative locations (femoral, subclavian, etc.) and 7 did not have line type documented.  134 were cultured from patients located on critical care units and 100 were from general medical floors. 98 (41.9%) of hubs yielded microbial growth. There was no significant difference in the rate of contamination when comparing clinical unit or line type. 

    Of the positive cultures, 64 (65.3%) had < 15 colony forming units (CFU), 17 (17.3%) had >15 CFU, and 17 (17%) had areas of confluent growth. Of those with confluent or > 15 CFU, there was an even distribution of line types. Based on visual plate inspection, all positive cultures consisted of gram-positive organisms.

    Conclusion: Bacterial colonization of the lever lock system was unacceptably high among all line types and hospital locations. This rate may be secondary to inappropriate scrubbing of catheter hubs or contamination of the hub during use. Causation of colonization cannot be determined with these results. Given the potential risk of CLABSI, there is however, a significant opportunity for further research to decrease colonization rates.

    Kelly Cawcutt, MD1, Richard Hankins, MD1, R Jennifer Cavalieri, RN2, Paul D. Fey, PhD3, Elizabeth Lyden, MS4 and Mark E. Rupp, MD, FIDSA, FSHEA2, (1)University of Nebraska Medical Center, Omaha, NE, (2)Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, (3)Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, (4)Epidemiology, University of Nebraska Medical Center, Omaha, NE

    Disclosures:

    K. Cawcutt, None

    R. Hankins, None

    R. J. Cavalieri, None

    P. D. Fey, None

    E. Lyden, None

    M. E. Rupp, None

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