Abstract: SA-PO1059
An Observation Relevant to Microbial Entry into Dialysis and Other Fluid and Blood Lines and Its Solution
Session Information
- Hemodialysis: Risk Factors, Epidemiology, and Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Author
- O'Neil, Terrence, HD CLEAN LLC, Londonderry, New Hampshire, United States
Background
There were 9548 hemodialysis central line-associated bloodstream infections (CLABSIs) reported in 2020 despite adoption of stringent catheter-care protocols. The prevailing hypothesis for CLABSIs is that staff touch bloodstream-facing parts of the connection during use, inoculating the lumen. However, physical characteristics of the connectors have been under-considered as part of the problem. Luer Locks are widely used to join tubing segments. Their screw threads have gaps that exert capillary action, drawing in fluids. Until January 2026 there was no literature showing this, resulting in under-appreciation of the role of Luer lock connectors harboring latent contamination not reached by disinfection protocols which can gain bloodstream access with repeated disconnection and reconnection.
Methods
Five drops of colored fluid surrogate for microbially contaminated fluid were administered to Luer Lock connectors. This was repeated three times and each time within 5 minutes fluid had penetrated deep into the female connector, out of reach of antiseptics.
A modification of the Luer Lock was made (Figure 2: Patent Pending) in which a compressible polymer grommet was placed on the male half where the female half of would terminate when fully screwed closed. This eliminated penetration of fluid applied to the connector.
Results
Unmodified Luer Lock connectors are subject to deep fluid penetration. A compressible rubber grommet on the male half of the connection prevents entry of fluid into the deep recesses of the female half of the Luer Lock.
Conclusion
Existing Luer Lock connectors could contribute to CLABSI's. Simple modification could potentially reduce bacteremia and sepsis when catheters are exposed to microbially-contaminated fluids. Further research is warranted.
Acknowledgment
A preliminary editorial containing some of the information reported above appeared in ASN Kidney News, Volume18 / Issue:1 08 Jan 2026, Page: 27, DOI: https://doi.org/10.62716/kn.002192025
Before & 3 min after applying fluid
Modified
Funding
- Commercial Support – HD CLEAN LLC ("A Service-Disabled Veteran-Owned Small Business")