The Impact of 70% Isopropyl Alcohol-Impregnated Disinfecting Caps on Needleless Connector Colonization in Ambulatory Pediatric Hematology-Oncology Patients

Objective: Totally implantable venous access devices (TIVADs) are essential in pediatric oncology but pose a risk of catheter-related infections. This study assesses the impact of 70% isopropyl alcohol-impregnated disinfecting caps on microbial colonization of needleless connectors (NCs) and extension set lumens. Design: This is a single-center, open-label, prospective study. Participants: The study included 23 pediatric patients (50 treatment episodes) with acute lymphoblastic leukemia using TIVADs. Methods: From April to July 2024, patients with double-lumen extension sets and needleless connectors (NCs) were included. One NC remained uncovered, while the other was capped with a 70% alcohol-impregnated disinfecting cap. Surface cultures were obtained from the uncovered NC on days 2, 3, and 4, and from the capped NC on day 4. Results: Microbial colonization was significantly higher in uncovered NCs (63.3%) than in capped NCs (2%) ( P < .001). Coagulase-negative staphylococci were the predominant isolates (88.4%). Intraluminal colonization was also higher in uncovered NCs (76% vs. 6%; P < .001). Conclusion: Alcohol-impregnated disinfecting caps significantly reduce microbial colonization of NCs and extension set lumens in pediatric oncology patients, suggesting their effectiveness in infection prevention.