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Certain needleless intravascular (I.V.) catheter access components significantly raise the risk of bloodstream infections, according to a recent report. Clinicians at the University of Nebraska Medical Center in Omaha noticed a dramatic rise in bloodstream infections following adoption of SmartSite Plus, a positive-displacement, luer-activated needleless I.V. connector valve. This type of connector expels a small amount of flush solution into the catheter when the device is disconnected to clear the catheter and prevent retrograde flow.


In the intensive care unit, the infection rate nearly tripled after this device was introduced. Similarly, the bloodstream infection rate in regular nursing units more than doubled. After the hospital stopped using these devices, infection rates returned to prior levels.


Researchers speculate that microbes and debris easily accumulate on the device's shallow depression and rim, inviting infection. The device's movable parts also introduce irregularities in fluid flow that may promote stagnation, creating favorable conditions for microbe growth. And the device is opaque, preventing visual inspection for problems.


Every hospital in the country is using similar devices, the researchers say. They've notified the Food and Drug Administration and the device's manufacturer (Alaris Products, CardinalHealth) of their findings.




Rupp ME, et al., Outbreak of bloodstream infection temporally associated with the use of an intravascular needleless valve, Clinical Infectious Diseases, June 1, 2007.