Method For Sterilization Of Needleless Connector Of PICC To Prevent Catheter-related Infections

Peripherally inserted central venous catheter (PICC) are used for both emergent and long-term vascular access for the infusion of numerous therapeutic agents such as chemotherapy, parenteral nutrition, antibiotics. Catheter-related infection (CRI) is the most common life-threatening complication of PICC.Domestic and international medical institutions to develop a series of measures to reduce the CRI, but ignore an important part in - catheter connector. Nowadays, hospital commonly in foreign countries and in most hospitals of our contries, used needleless connector connection to the catheter. U.S. Centers for Disease Control (CDC) published "Prevention of intravascular catheter-related bloodstream"(2006 ) that led to catheter tube interface is an important cause of microbial colonization, especially in longer indwelling catheter. According to statistics, more than 1 week time catheters interfaces as a result of blood transfusion-related infection accounted for 5l%. In our research a large number of clinical cases by analysis of an improved method of disinfection.OBJECTIVE:To improve the method for sterilization of needleless connector of PICC in oncology patients, to raise the effect of sterilization, and choose the matched luer-lock device, to decrease catheter-related infections.METHODS : The clinical data of 321 oncology patients receiving peripherally inserted central venous catheterization between May 2009 and May 2010 were reviewed retrospectively. All patients were randomized to divide into three groups,an experiment group , a control group A and a control group B, and each group included 107 patients. The modified methods were adopted in the experiment group while the conventional methods were adopted in the two control groups.Group A adopt 75% alcohol cotton to annular disinfect needleless connectors for 15 seconds. Group B adopt 75% cotton ball to roll needleless connectors for 15 seconds. The two groups chose the common devices to match needleless connectors. The experiment group adopt alcohol pad to roll needleless connectors for 15 seconds, and chose spiral devices to match needless connectors. Compare the incidence rate of CRI and bacterial distribution among three groups.RESULTS : The incidence rate of exit-site infection and catheter colonization in the experiment group were respectively 5.6% and 1.9%, obviously lower than that of the two control groups (P< 0.05).The incidence rate of CRBSI in the experiment group was 0.0%, lower than that of the two control groups.Catheter infection pathogens mainly Gram-positive bacteria, accounting for 72.4%, 24.1% Gram-negative bacteria, fungi accounted for 3.5%.CONCLUSIONS:The modified methods for the sterilization of needleless connector in experiment group distinctly reduce the occurrences of the catheter-related infections. This modified method Not only alleviate the suffering of patients, but also reduce the economic burden of patients, shorter hospital stay, it is widely used in clinical practice and promotion.