Comparison of the microbial barrier properties of a needleless and a conventional needle-based intravenous access system

Background: Sporadic reports of increased infection rates involving needleless access systems, especially in home-care settings, have raised questions concerning the safety of all needleless systems. Addressing this concern, Baxter Healthcare Corporation and the Centers for Disease Control and Prevention performed parallel laboratory studies comparing the microbial barrier properties of the Interlink (trademark of Baxter Healthcare Corporation, Deerfield, Ill) needleless system with a conventional intravenous access system. Methods: Studies of needleless and conventional systems evaluated fluid path contamination introduced through injection site septa, which were intentionally inoculated with high levels of bacteria and subsequently punctured with and without alcohol swabbing disinfection before access. Results: With disinfection, the combined effects of the disinfection technique and the barrier properties of the septa prevented the transfer of organisms into the fluid path in 94% to 96% of needleless test articles and 96% to 100% of conventional test articles. Without disinfection, the barrier properties of the septa alone prevented the transfer of organisms into the fluid path in 20% to 69% of needleless test articles and 10% to 28% of conventional test articles. Conclusions: The data demonstrate the needleless system performs as well as the conventional intravenous access system with respect to the risk of microbial contamination and reinforce the need for appropriate septum disinfection before accessing either system (AJIC Am J Infect Control 1998;26:437-41).