Maragakis LL, Bradley KL, Song X, et al. Increased Catheter-Related Bloodstream Infection Rates after the Introduction of a New Mechanical Valve Intravenous Access Port. Infection Control and Hospital Epidemiology 2006; 27: 67-70.

• “the fluid path in the mechanical valve devices has moving parts, and at least one of the mechanical valve devices have internal corrugations that may serve as reservoirs and foster the growth of microbial contaminants.”
• “the mechanical valve devices have intricate access surfaces that are more difficult to disinfect…”
• “some of the devices have been noted by healthcare personnel to have incomplete flushing of blood from the fluid channel, and some are opaque, so that this would not be readily apparent to the user”

Field K, McFarlane C, Cheng AC, et al. Incidence of Catheter-Related Bloodstream Infection Among Patients with a Needleless, Mechanical Valve–Based Intravenous Connector in an Australian Hematology-Oncology Unit. Infection Control and Hospital Epidemiology 2007; 28:610-613.

• “risk of colonization of the connector device may be higher for mechanical valve devices because of the potential difficulty in sterilizing the gap between the valve and the hub”

Salgado CD, Chinnes L, Paczesny TH, Cantey JR. Increased Rate of Catheter-Related Bloodstream Infection Associated with Use of a Needleless Mechanical Valve Device at a Long-Term Acute Care Hospital. Infection Control and Hospital Epidemiology 2007; 28:684-688.

• “the mechanical valve system could be more difficult to disinfect because of the complicated nature of the multipart device.”

Rupp ME, Sholtz LA, Jourdan DR, et al. Outbreak of Bloodstream Infection Temporally Associated with the Use of an Intravascular Needleless Valve. Clinical Infectious Disease 2007; 44:1408-1414

• “a shallow depression and rim between the diaphragm and plastic housing...It is possible that microbes and debris could collect in this area, which would be relatively resistant to cleansing or disinfection”
• “internal mechanism of the valve contains moving parts, which introduces irregularities in the fluid flow and may promote areas of stagnation and create potential reservoirs for microbial growth. Also the plastic housing is opaque, which prohibits visual inspection of the connector valve.”