Abstract

A prospective survey to evaluate rate of intravenous needle contamination was conducted at Infectious Diseases Hospital of Jakarta among patients whom received intravenous (i.v.) fluid or transfusion during 1 year period in 1982-1983. The survey was conducted through random culture of the distal part of the intravenous needle placed in the patients vein after completion of intravenous treatment. The exact time for the needle placement and extraction, local and systemic reactions observed in patients, were all recorded. From 559 culture of the i.v. needles which fulfilled the survey criteria, 238 were positive, indicating 42.3% contamination rate of the i.v. needles. The rate was higher in febrile patients (47.2%) compared to diarrhea patients (41.5%) Average duration of infusion (the duration of time the needle stayed in the vein) was 38.9 hours, with average of 15.8 hours in diarrhea patients and 104,6 hours in febrile patients. Mean duration of time for local reaction development was 36.8 hours, with 24.3 hours in diarrhea patients and 65.9 hours in febrile patients. Patients with positive culture had higher rate of local reaction (17.6% vs 13.4%), systemic reaction (18.4% vs 11.8%), nosokomial bacteremia (88% vs 4,4%) and community acquired infection (5.9% vs 3.7%) compared to patients with negative cultures. For patients with longer than 48 hours infusion, 58.5% had positive culture from i.v. needles, 21.9% had local reaction, 40.2% had systemic reaction which all were higher compared to patients who had less than 48 hour infusion with p<0.001, p<0.02 and p<0.001 respectively. Isolated bacteria from i.v. needles were 74.6% gram positive bacterias and 25.4% gram negative, with Staphylococcus epidermidis (38%) as the leading positive culture. Isolated bacteria had high rate of resistancy 'oward commonly used antibiotics in the hospital.