Clinical Study On The Indwelling Time Of Needleless PICC Infusion Connector In Tumor Patients With Chemotherapy

Objective:This research describes the bacterial and enrichment culture of different indwelling times of needleless infusion connectors used for tumor patients having PICC chemotherapy to explore the reasonable indwelling time for different types of needleless infusion connectors,and investigates the effect of different structures of needleless infusion connectors on catheter-related infections.It provides clinical recommendations,rational use of different types of needleless infusion connectors,and develops strategies to prevent catheter-related infections in patients with PICC chemotherapy.Methods:This study is a cross-sectional study.A survey was conducted on 263 tumor patients with PICC in a top three hospital in Bengbu City.The replaced needleless infusion connectors during catheter maintenance were collected and divided into three types according to the type of infusion connector:Type A(Positive pressure connector with opaque metal spring mechanical valve),Type B(transparent silicone mechanical valve positive pressure connector),Type C(separation membrane negative pressure connector).Bacterial and enriched culture tests were performed on the three types of needleless infusion connectors after different indwelling times.Then,the bacteria-free and enriched culture results of the three types of needleless infusion connectors were analyzed.SPSS 22.0 software was used for data entry,and Fisher's exact probability method was used for data analysis of 263 samples.When P <0.05,the difference was statistically significant.Results:(1)Of the 263 patients,97 patients used type A needleless connectors,86 patients used type B needleless connectors,and 80 patients used type C infusion connectors.A total of 23 patients had positive results of bacterial culture,that is,the colonization of catheter bacteria.The colonization rate of catheter bacteria was 8.75%.Among them,13 cases were type A needleless connectors,and the bacterial colonization rate of catheter was 13.4%;6 cases were type B needleless connectors,and the bacterial colonization rate of catheter was 6.98%;4 cases were type C needleless connectors,the colonization rate of catheter bacteria was 5%.There were no other types of catheter-related infections in this study.(2)There were no differences in the bacterial culture conditions and enrichment culture conditions of the three needleless connectors A,B,and C with different indwelling times,P> 0.05.The three types of needleless connectors A,B,and C had a higher rate of bacterial colonization in the catheter compared with the indwelling period of 4~7 days compared with the indwelling period of 8~14 days.When type A needleless connector were remained for 8~14 days,and B and C needleless connectors were remained for 15~21 days,compared with the bacterial culture experiment,the positive result of the bacteriostatic tester the enrichment culture test increased least.(3)The comparison of the bacterial culture results of the three infusion connector type A,B,and C with the same indwelling time of the rinse fluid,the difference was not statistically significant,P> 0.05.(4)In the three kinds of needleless infusion connectors bacteria and enriched culture experiments,a total of 12 species of bacteria were isolated,of which Gram-positive bacteria were Staphylococcus aureus(including Staphylococcus hemolyticus,Staphylococcus human,Staphylococcus epidermidis,Staphylococcus aureus,Staphylococcus woi)and Bacillus(including Bacillus cereus,Lysine sphaericus,Bacillus pumilus),accounting for 94.4%.Gram-negative bacteria includes: Acinetobacter(Acinetobacter jones)and Escherichia coli,accounted for 5.6%.Conclusion:Under the premise of strict aseptic technique,the indwelling time of the needleless infusion connector is at least 7 days.For patients using type A needleless connector,the indwelling time of the needleless connectors should not exceed 14 days and the indwelling time of the type B and C needleless connectors should not exceed 21 days.Needleless connectors with relatively smooth surfaces and no gaps at the edges have less influence on catheter-related infections.The difference in the internal structure of the needleless connector has less influence on the bacterial colonization of the catheter.