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. 2022 Apr;8(2):98-104.
doi: 10.1136/bmjinnov-2021-000845. Epub 2022 Jan 28.

Design and proof-of-concept evaluation of a touchless connector system for preventing peritoneal dialysis-associated peritonitis

Ibrahim O Yekinni  1 , Tom Viker  2 , Ryan Hunter  3 , Aaron Tucker  1 , Sarah Elfering  4 , Michelle N Rheault  5 , Arthur Erdman  1
Affiliations

Design and proof-of-concept evaluation of a touchless connector system for preventing peritoneal dialysis-associated peritonitis

Ibrahim O Yekinni et al. BMJ Innov. 2022 Apr.

Abstract

Introduction: In this paper, we describe the design of a touchless peritoneal dialysis connector system and how we evaluated its potential for preventing peritoneal dialysis-associated peritonitis, in comparison to the standard of care. The unique feature of this system is an enclosure within which patients can connect and disconnect for therapy, protecting their peritoneal catheters from touch or aerosols.

Methods: We simulated a worst-case contamination scenario by spraying 40mL of a standardized inoculum [ 1×107 colony-forming units (CFU) per milliliter] of test organisms, Staphylococcus epidermidis ATCC1228 and Pseudomonas aeruginosa ATCC39327, while test participants made mock connections for therapy. We then compared the incidence of fluid path contamination by test organisms in the touchless connector system and the standard of care. 4 participants were recruited to perform a total of 56 tests, divided in a 1:1 ratio between both systems. Peritoneal dialysis fluid sample from each test was collected and maintained at body temperature (37° C) for 16 hours before being plated on Luria Bertani agar, Mannitol Salts Agar and Pseudomonas isolation agar for enumeration.

Results: No contamination was observed in test samples from the touchless connector system, compared to 65%, 75% and 70% incidence contamination for the standard of care on Luria Bertani agar, Mannitol Salts Agar and Pseudomonas isolation agar respectively.

Conclusion: Results show that the touchless connector system can prevent fluid path contamination even in heavy bacterial exposures and may help reduce peritoneal dialysis-associated peritonitis risks from inadvertent contamination with further development.

Keywords: Infections; Nephrology; Peritoneal Diseases.

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Conflict of interest statement

Competing Interests IOY, AT and TV invented the touchless connector. TV is an employee of Cerovations LLC, a company that has licensed the connector from the University of Minnesota for commercialization.

Figures

Figure 1:
Figure 1:
Peritoneal dialysis connector system designs (a) Standard of care connector system (b) Touchless connector system
Figure 2:
Figure 2:
3D rendering showing design evolution of the touchless connector system
Figure 3:
Figure 3:
Current injection molded prototype of touchless connector system
Figure 4:
Figure 4:
Experimental setup
Figure 5:
Figure 5:
Contamination on Luria Bertani Agar CFU/mL = Colony Forming Units/mL
See this image and copyright information in PMC

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