Disinfection of vascular catheter connectors that are protected by antiseptic caps is unnecessary

Infect Control Hosp Epidemiol. 2024 Jan;45(1):35-39. doi: 10.1017/ice.2023.148. Epub 2023 Jul 19.

Abstract

Objective: Determination of whether vascular catheter disinfecting antiseptic-containing caps alone are effective at decreasing microbial colonization of connectors compared to antiseptic-containing caps plus a 5-second alcohol manual disinfection.

Setting: The study was conducted in a 718-bed, tertiary-care, academic hospital.

Patients: A convenience sample of adult patients across intensive care units and acute care wards with peripheral and central venous catheters covered with antiseptic-containing caps.

Methods: Quality improvement study completed over 5 days. The standard-of-care group consisted of catheter connectors with antiseptic-containing caps cleaned with a 5-second alcohol wipe scrub prior to culture. The comparison group consisted of catheter connectors with antiseptic-containing caps without a 5-second alcohol wipe scrub prior to culture. The connectors were pressed directly onto blood agar plates and incubated. Plates were assessed for growth after 48-72 hours.

Results: In total, 356 catheter connectors were cultured: 165 in the standard-of-care group, 165 in the comparison group, and 26 catheters connectors without an antiseptic-containing cap, which were designated as controls. Overall, 18 catheter connectors (5.06%) yielded microbial growth. Of the 18 connectors with microbial growth, 2 (1.21%) were from the comparison group, 1 (0.61%) was from the standard-of-care group, and 15 were controls without an antiseptic-containing cap.

Conclusions: Bacterial colonization rates were similar between the catheter connectors cultured with antiseptic-containing caps alone and catheter connectors with antiseptic-containing caps cultured after a 5-second scrub with alcohol. This finding suggests that the use of antiseptic-containing caps precludes the need for additional disinfection.

MeSH terms

  • Adult
  • Anti-Infective Agents, Local* / pharmacology
  • Catheter-Related Infections* / prevention & control
  • Catheterization, Central Venous*
  • Central Venous Catheters*
  • Chlorhexidine / pharmacology
  • Disinfection
  • Equipment Contamination / prevention & control
  • Ethanol
  • Humans

Substances

  • Anti-Infective Agents, Local
  • Ethanol
  • Chlorhexidine