Blood drawn through valved catheter hub connectors carries a significant risk of contamination

• Published in: European journal of clinical microbiology & infectious diseases Vol. 30; no. 12; pp. 1571 - 1577
• Main Authors: Sherertz, R. J., Karchmer, T. B., Palavecino, E., Bischoff, W.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.12.2011; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; Bacteremia - diagnosis; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Blood; Blood - microbiology; Catheters; Catheters - microbiology; Connectors; Disease control; Education; False Positive Reactions; Female; Gram-negative bacteria; Health surveillance; Humans; Infections; Infectious diseases; Internal Medicine; Male; Medical instruments; Medical Microbiology; Medical sciences; Medicine; Middle Aged; Pathogens; Patients; Pollution control; Specimen Handling - methods; Young Adult; United States > US; Skin Organism; Peripheral Blood Culture; Positive Blood Culture; Blood Culture; Central Venous Catheter; Infection; Catheter; Microbiology; Contamination; Blood; Risk factor
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-011-1262-6

Infection Control became concerned when bloodstream infection (BSI) rates increased after implementing a needleless valved hub connector. During a 21-month period three different needleless catheter hub connectors were evaluated by quantitatively culturing blood drawn through hub connectors that would have ordinarily been discarded (DBC). DBC drawn through Clearlink™ catheter hub connectors were found to be twice as likely to be positive as DBC drawn through Clave® or Q-syte™ hub connectors ( P  < 0.04). DBC grew pathogens 46% of the time and skin organisms 54% of the time. Patients with positive DBC were three times more likely to meet Centers for Disease Control (CDC) BSI criteria by DBC cultures than by physician-ordered blood cultures (CBC; P  < 0.001). For patients growing pathogens in DBC, 64% had no CBC drawn, the average temperature was lower than for patients with pathogens in CBC (99.3 ± 1.5 ve 100.6 ± 1.9, P  = 0.015), and 92% of discharged patients (11 out of 12) were not treated with an antibiotic active against the DBC pathogen. Drawing BC through a catheter hub connector carries a risk of false-positives that could increase BSI rates by up to 3-fold. Further work is necessary to evaluate this concern.