Improvement of a small, inexpensive disposable device could be the key to preventing hospital-acquired bloodstream infections, says a nurse researcher at Georgia Health Sciences University (formerly the Medical College of Georgia).
Dr. Cynthia Chernecky, Professor of Physiological and Technological Nursing, will speak today at the 11th National Conference on Cancer Nursing Research in Los Angeles on the connection between needleless intravenous connector technology and catheter-related bloodstream infections, which have an up to 25 percent mortality rate.
“This technology was initially created in the early 1990s to prevent accidental needlestick injuries and the spread of hepatitis and HIV,” said Chernecky. “The thought was to get away from needles. There was no consideration about preventing other infections or occlusions, the blood clots that can lead to infection.”
Ironically, that needleless technology is now implicated as a cause of potentially deadly bloodstream infections.
Studies have shown higher bloodstream infection rates due to occlusions in connectors which appear unable to control bacterial growth in blood that pools in the dead space within the fluid pathways of the devices.
Some manufacturers have added recently added silver treatments, which have antibacterial properties, to their IV connectors. However, that protection appears to be lost when the silver-treated fluid pathway components come in contact with blood.
“We think the blood has some sort of coating effect that makes the silver ineffective,” Chernecky said. “The problem is the U.S. Food and Drug Administration approved the connectors without asking for a blood component to be part of the data.”
Chernecky analyzed study data on three silver-treated needleless IV connectors, each of which grew bacteria when introduced to blood.
“We think the blood has some sort of coating effect that makes the silver ineffective in killing significant amounts of bacteria,” Chernecky said. “The problem is the U.S. Food and Drug Administration approved these devices without a required blood component to be part of the methodology.”
Only one, the RyMed Technologies InVision-Plus® CS™ with Chlorhexidine/Silver Ion engineering, introduced last month, precludes blood contact by combining silver and chlorhexidene. Approved by the FDA for up to seven days of use, it demonstrated effectiveness in killing the eight common microorganisms associated with catheter-related bloodstream infections, including MRSA.
The synergy of both silver and chlorhexidene is key to the improved performance, Chernecky said.
The FDA is requiring manufacturers to prove within three years that their needleless IV connector devices do not increase catheter-related bloodstream infections, a task Chernecky said would be expedited by requiring a blood component test protocol when evaluating needleless IV connector products.
Source: Georgia Health Sciences University