Preparation of B. Braun Easypump® II elastomeric devices with Chemfort™ closed system transfer devices (CSTDs) in uncontrolled environments
Louisa Knowles, Abi JenkinsAbstract
Background
Outpatient parenteral antimicrobial therapy (OPAT) enables patients to receive intravenous antimicrobials outside hospital settings. Elastomeric infusion devices facilitate continuous antibiotic delivery; however, limited stability data and constrained aseptic unit capacity have led some services to adopt nurse-led ‘fresh-fill’ preparation in uncontrolled environments, which may increase microbial contamination risk.
Objectives
To evaluate whether preparation of B. Braun Easypump® II elastomeric devices using Chemfort™ closed system transfer devices (CSTDs) in uncontrolled environments reduces microbial contamination compared with preparation using needles and syringes.
Methods
Forty-six elastomeric devices were prepared with tryptic soy broth by eight operators across three uncontrolled rooms using either Chemfort™ CSTDs (n = 23) or needles and syringes (n = 23). Aseptic non-touch technique was followed. Devices were incubated at 32°C for 7 days before microbiological testing. Environmental monitoring included settle plates and finger dabs. Fisher’s exact test was used to analyse contamination rates.
Results
No contamination occurred in devices prepared using CSTDs (0/23), whereas 5/23 (22%) prepared using needles were contaminated. This difference was statistically significant (P = 0.0491). Preparation times were shorter and more consistent using CSTDs (median 26 min; range 20–40) compared with needles and syringes (median 34 min; range 22–64).
Conclusions
Preparation using Chemfort™ CSTDs was associated with reduced microbial contamination and shorter preparation times compared with needle-based methods. CSTDs may provide a useful risk-reduction strategy for nurse-prepared elastomeric infusions in OPAT services, although further evaluation in larger studies is required.