D-076. Evaluation of Intravascular Needleless Connector Ability to Mitigate Colonization with S. epidermidis and MRSA

H. J. Maudlin1, C. R. Estling1, J. M. Tippett2, D. Gervich2, J. T. Gray1;
1Des Moines Univ., Des Moines, IA, 2Mercy Med. Ctr., Des Moines, IA.

Because of needle-stick injuries and healthcare worker exposure to bloodborne pathogens, most institutions have adopted the use of needleless connectors (NCs). While increasing healthcare worker safety associated with IV access lines, the NCs have been documented to increase the risk for bloodstream infections, inducing considerable morbidity and mortality. Pathogens commonly associated with this include Staphylococcus epidermidis and Staphylococcus aureus. A reproducible assay was developed to evaluate an NC’s ability to establish and support clinical and reference isolates of methicillin-resistant S. aureus (MRSA) and S. epidermidis. Five NC types were tested: Clave, ICU Medical; MaxPlus, Medegen Medical; Posiflow, BD Products; Q-Syte, BD Products; and Ultrasite, B. Braun Services. NCs were inoculated with 200 cfu of organism and the organism recovery was performed using methodology designed for the species of pathogen targeted. NCs were evaluated at 30 min, 4hr and 24hr post inoculation. Significant differences were observed for NC colonization. At 4 hrs post inoculation with S. epidermidis, organisms were recovered indicating that colonization of the Clave and MaxPlus < Posiflow < Q-Syte and Ultrasite (p-value < 0.05). With MRSA as the target pathogen, at 4 hours post-inoculation colonization levels indicated that the Clave and MaxPlus < Posiflow, Q-Syte and Ultrasite (p < 0.05). At 24 hrs post inoculation, significant differences were observed for S. epidermidis colonization, with MaxPlus and Clave < Posiflow and Q-Syte < Ultrasite (p < 0.05). For MRSA at 24 hrs post inoculation, colonization levels were observed as MaxPlus, Clave and Posiflow < Q-Syte and Ultrasite (p < 0.05). With the methods developed, the organism colonization rate vs. the organism recovery rate did not differ between MRSA and S. epidermidis. However, MRSA requires a more rigorous recovery process indicating more adherence to the NC surface. Significant differences were observed between bacterial strains within a species. This study provides the initial basis for a method to evaluate NCs on their ability to mitigate bloodstream infections.

133/D. Haemophilus and Moraxella

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