The relationship between intravenous infusate colonisation and fluid container hang time

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Title The relationship between intravenous infusate colonisation and fluid container hang time
Author Rickard, Claire; Vannapraseuth, Boun; McGrail, Matthew R; Keene, Lorraine J; Rambaldo, Sam; Smith, Chloe A; Ray-Barruel, Gillian Anne
Journal Name Journal of Clinical Nursing
Year Published 2009
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing
Abstract Aims. To examine the level of microbial colonisation in intravenous fluids after 24 hours of use in an acute care setting to determine the necessity of changing infusate bags on a time-related basis. Background. Catheter-related bloodstream infections are a serious and life-threatening complication of intravascular devices. Colonised intravenous fluids are one potential source of infection; however, there is little published literature on incidence rates and few recent studies. Routine intravenous fluid replacement has been advocated as an infection control method, but the effectiveness of this is unknown and the optimal duration for infusate use remains uncertain. Design. Cross-sectional study over 18 months in a 257-bed teaching hospital. Methods. Infusate specimens (n = 264) were obtained from crystalloid fluids that had been used for 24 hours or more. Microbiological culture and sensitivity testing was performed and infusate-related bloodstream infection (IRBSI) rates were recorded. Sample testing of previously unopened intravenous solutions acted as a control. Results. The infusate colonisation rate was 0·4%, or 0·09 per 1000 infusion hours. The only isolated organism was coagulase-negative Staphylococcus. Infusions had been in use for 24–185 hours (1–8 days). There was no difference in median duration of use for colonised (35·0 hours) and sterile (34·0 hours) specimens (Mann–Whitney test, p = 0·99). There were no cases of IRBSI. Conclusion. The incidence of intravenous fluid colonisation and the risk of related bloodstream infection are low even after several days of infusate use. Current practice appears to successfully maintain the sterility of intravenous fluids. Relevance to clinical practice. Routine replacement of intravenous fluids continues in many settings, often 24 hourly, in the belief that this prevents infection. We found no relationship between duration of use and colonisation and routine replacement may be unnecessary. Further research is needed to investigate the effectiveness of routinely replacing intravenous fluids at set time points to prevent colonisation and infection.
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Copyright Statement Copyright 2009 Wiley-Blackwell Publishing. This is the author-manuscript version of the paper. Reproduced in accordance with the copyright policy of the publisher.The definitive version is available at
Volume 18
Issue Number 21
Page from 3022
Page to 3028
ISSN 0962-1067
Date Accessioned 2009-07-27
Language en_AU
Research Centre Centre for Health Practice Innovation; Menzies Health Institute Qld
Faculty Griffith Health Faculty
Subject Clinical Nursing: Secondary (Acute Care); Infectious Diseases
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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