Microbiological comparison of a silver-coated and a non-coated needleless intravascular connector in clinical use

Background: The potential for microbial contamination of needleless intravascular (IV) connectors and the risk of subsequent infection are currently a subject of debate. Aim: To compare the number of micro-organisms associated with silver-coated and non-coated connectors in a clinical setting. Methods: Twenty-five patients with haematological malignancies who required a central venous catheter (CVC) as part of their clinical management were studied. Each patient's CVC was randomly designated to have attached either silver-coated or non-coated connectors. Before and after each manipulation of the connectors, the compression seals were decontaminated with a wipe incorporating 2% (w/v) chlorhexidine gluconate in 70% (v/v) isopropyl alcohol. Following four days in situ, the number of micro-organisms recovered from 119 silver-coated and 117 non-coated connectors was determined. Findings: Thirty-six (30.3%) silver-coated connectors had micro-organisms present on the external silicone compression seal compared to 41 (35%) non-coated connectors [odds ratio (OR): 0.8; 95% confidence interval (CI): 0.47-1.39; P = 0.49]. Conversely, the internal fluid pathway of 31 (26.1%) silver-coated connectors had micro-organisms present compared to 55 (47.0%) of the non-coated connectors (OR: 0.40; 95% CI: 0.23-0.69; P = 0.001). In addition, the total number of micro-organisms present was less in the silver-coated connectors as compared to non-coated devices (P = 0.001). Conclusion: The use of a silver-coated connector with a dedicated decontamination regime may reduce the risk of catheter-related bloodstream infection acquired via the intraluminal route. (C) 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.