Microbial Colonization of Intravenous Luer Lock Connector During Active Infusions Among Hospitalized Patients

BACKGROUND: Central line associated bloodstream infections (CLABSI) result in patient morbidity and increased length of stay. While most CLABSI’s are due to extraluminal carriage of skin flora into the bloodstream, catheter hub colonization and intraluminal carriage remains a possible cause. We have previously evaluated a lever lock catheter in hospitalized patients, which had a 41.9% bacterial colonization rate. After replacing the lever lock system with a leur lock catheter system and passive port protector, we evaluated the colonization rate of this luer lock catheter system. METHODS: A prospective 3 day study was performed evaluating the microbial colonization of the luer lock system in hospitalized patients with active infusions. Infusions were assessed, and if not deemed critical or an antimicrobial, paused while the catheter connector hub was used to inoculate a blood agar plate. After 48–72 hours the plates were evaluated for microbial growth. RESULTS: 243 catheter connector hubs were cultured: 68 catheters were peripherally inserted central catheters, 60 were internal jugular venous lines, 93 were peripheral venous catheters, and 25 were others (femoral, subclavian, etc). 56 hubs (23.0%) yielded microbial growth. 176 of the hubs (71.5%) tested were in an ICU setting, and 70 (28.5%) were from an acute care ward. In comparing the luer lock system to the previously evaluated lever lock system, there was a reduced rate (P < .0001) of colonization. This reduction in the rate of colonization of the luer lock system was significant in the ICU (P < .0002). There was no difference seen in the colonization rate of the two systems in the acute care wards (P < .11). CONCLUSION: The luer lock system provided a significant reduction in colonization rates of catheters hubs, particularly in the ICU. However the observed 23% colonization rate remains unacceptably high. Causation of colonization is unable to be determined by this study. Given the potential for catheter hub colonization to increase the risk of CLABSI, the opportunity exists for further research. DISCLOSURES: All authors: No reported disclosures.