Decontamination of the needleless connector: an in vitro study

Ms Julie Flynn1,2, Prof Claire Rickard1,2, Prof Samantha Keogh1,3, Dr Li Zhang2

1Royal Brisbane & Women’s Hospital, Brisbane, Australia,

2Griffith University, Brisbane, Australia,

3QUT, Brisbane, Australia


Introduction: The primary aim of this project was to determine the most effective method for needleless connector decontamination when comparing: usual practice (70% isopropyl alcohol (IPA)); CHG in 70% IPA; or a 70% IPA impregnated NC cap.

Methods: This is an in vitro study. Three different types of needleless connectors (n=648) were subjected to bacterial or fungal contamination (Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa and Candida albicans) prior to being decontaminated using one of three different methods: Chlorhexidine Swabs (2% chlorhexidine gluconate + 70% IPA); Alcohol Swabs (70% IPA); or Alcohol Impregnated Caps (70% IPA). Half of the connectors were pre-treated with human serum to mimic real life use.

Results: Differences between needleless connector type and organisms were negligible, therefore results were pooled and mean and standard deviation calculated per decontamination method. Chlorhexidine swabs outperformed the IPA only groups, with 70% IPA, even with a 30 second decontamination timeframe, showing only a ~30% reduction of organisms. Serum exposure also minimised the effect of decontamination across all study groups.

Conclusion: The significance of the findings in this controlled laboratory study needs to be elucidated in the clinical scenario also under defined conditions, including a clearly defined decontamination process applied before and after each access. This will inform clinicians and policy makers about infection prevention strategies that may need to be modified. These changes will significantly influence the prevention of CABSI, and optimise healthcare services.



Julie is a Registered Nurse, a Senior Research Assistant and a PhD candidate at the Griffith University. She is passionate about the decontamination of the neddleless connector – which is her PhD topic.