Contamination of central venous catheters. The skin insertion wound is a major source of contamination

• Published in: The Journal of hospital infection 1996-02, Vol.32 (2), p.99-104
• Main Authors: Egebo, K., Toft, P., Jakobsen, C.-J.
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; bacterial contamination; Biological and medical sciences; catheter related sepsis; Catheterization, Central Venous; Catheterization, Swan-Ganz; Central venous catheters; Emergency and intensive care: techniques, logistics; Equipment Contamination; Humans; Intensive care medicine; Medical sciences; Perfusions. Catheterizations. Hyperbaric oxygenotherapy; Prospective Studies; Serratia - isolation & purification; Skin - microbiology; Staphylococcus - isolation & purification
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/S0195-6701(96)90051-1

In a prospective controlled trial we compared the rates of catheter-tip contamination in central venous catheters inserted with or without skin contact. The study was designed so that each patient was their own control. All patients had a single-lumen central venous catheter and a Swan-Gantz sheet inserted through the skin. A Swan-Gantz catheter was inserted and retracted through the sheet thus avoiding contact with skin or subcutaneous tissue. Catheter-tip cultures were performed on removal of catheters. Thirty-three Swan-Gantz catheters were cultured and all were sterile. In the corresponding 33 sheets 16 (48·6%) yielded bacterial growth. Four of the sheets showed growth of more than 15 cfu. In the 26 singlelumen catheters, eight (30·8%) catheter-tips grew bacteria, and four of them had more than 15 colonies. The study supports the theory that the skininsertion wound is a major source of catheter-contamination.