Catheter-hub contamination is one of the five primary causes of central catheter infection. A recent study evaluated the use of disinfection caps in luer access valves to decrease bacterial contamination and infection rates. The caps contained a sponge saturated with 70% isopropyl alcohol affixed to the catheter hub.

The researchers measured contamination rates in blood samples taken from the intraluminal catheter space of peripherally inserted central venous catheters, as well as central line-associated bloodstream infections among patients with any central venous catheter. These outcomes were recorded during three phases, the first with standard care, in which an alcohol wipe was used to scrub the hub before accessing lines; the second with the disinfection caps; and the third again with standard care. The study took place at four acute care facilities in the Chicago area.

A total of 799 patients were enrolled. During baseline and phase 3, the contamination rates were 13% and 12%, respectively; in phase 2 the rate was significantly lower, at 6%. Coagulase-negative Staphylococcus species were the most commonly identified bacteria. Bloodstream infections occurred at rates of 1.45 per 1,000 line days in phase 1, 0.74 in phase 2, and 1.31 in phase 3.

According to the authors' estimates, for just over $2 per day per catheterized patient, use of the disinfection caps could result in 21 fewer infections and four fewer deaths per year.

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