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A Comparative Study on the Contamination Level of Intravenous Infusion Ports: A Comparison of 3-way Stopcock (Open-system) and Needleless Connector (Closed-system)

Background: This study was conducted to evaluate the level of intravenous injection port contamination in 3-way stopcock (open-system) or needleless connector (closed-system) intravenous infusion devices before and after disinfecting for 3 seconds with alcohol cotton. Methods: Eighty patients who underwent intravenous infusion therapy from April 1, 2018, to June 30, 2018, in a surgical intensive care unit were included. The sampling time was 48 hours after intravenous injection. Patients received 3-way stopcock or needleless connectors in intravenous infusion devices. The device was wiped with alcohol cotton for 3 seconds. Before and after the disinfection of each intravenous infusion port, the intravenous injection port was swapped with a sterile swab. The number of colonies was compared using the blood agar plate medium. Results: There was a significant difference in the number of colonies between the devices (P=0.001). The number of total colonies was much less in the needleless connectors than in the 3-way stopcock. There was no difference after disinfection of the injection port for 3 seconds, but the number of colonies in the needleless connector was lesser than that in the 3-way stopcock. Conclusion: Needleless connector systems (closed-system) are subject to a lower contamination level than 3-way stopcock systems (open-system). It was confirmed that 3 seconds of disinfection time of the intravenous infusion port is insufficient to decrease bacterial colonization.