Comparison of the standard pour plate procedure and the ATP and Limulus amebocyte lysate procedures for the detection of microbial contamination in intravenous fluids

Abstract

The intrinsic and extrinsic microbial contamination of large-volume parenterals has been associated with bacteremias in hospitalized patients. When epidemiologic data suggest the association of contaminated intravenous (i.v.) fluids with disease, appropriate laboratory methods must be devised to analyze quickly the suspect fluid. A study was undertaken to compare three laboratory test methods (standard pour plate [SPP] technique, ATP procedure, and Limulus amebocyte lysate [LAL] assay) for detecting the presence of microorganisms in artificially contaminated i.v. fluid. SPP proved the most sensitive of the assay techniques used, but a 24-h period was required for microbial growth. The LAL assay appeared more sensitive in detecting i.v. contamination than the ATP method. These studies suggest that the LAL and ATP methods can be used for the rapid detection of microbial contamination in i.v. fluid. SPP and LAL procedures would have practical laboratory application when the contamination of i.v. fluids is suspected, and they are more sensitive in detecting microbial contamination in these solutions than the ATP method.

Quality Control of Compounded Crystalloid Fluids for Intravenous Delivery to Horses

“…The finding that the majority of hand‐mixed fluids were contaminated with gram‐negative organisms is important because their presence in a solution is more likely to result in higher concentrations of endotoxin . We did find EU in one of the hand‐mixed fluid preparations that also grew a gram‐negative bacterium ( Cupriavidus sp .).…”

“…The finding that the majority of hand-mixed fluids were contaminated with gram-negative organisms is important because their presence in a solution is more likely to result in higher concentrations of endotoxin. 9 We did find EU in one of the hand-mixed fluid preparations that also grew a gram-negative bacterium (Cupriavidus sp.). However, the endotoxin at a concentration of 0.03 EU/mL was low and, based on limited available published reports, unlikely to cause clinical signs of endotoxemia.…”

Microbial Contamination due to Malpractice during Administration of Intravenous Fluids in Baghdad Hospitals

“…Between summer 1970 and March 1971, many U.S. hospitals experienced outbreaks of intravenous-associated septicemia with Enterobacter cloacae and Enterobacter agglomerans [9,10] . The intrinsic and extrinsic microbial contamination of largevolume parenterals has been associated with bacteremias in hospitalized patients [11] , and nosocomial infections associated with the intrinsic and extrinsic microbial contamination of large-volume parenterals, such as glucose-containing solutions, are well documented [12,13,14,15,16] . Although intrinsic (i. e., from the manufacturer) infusate contamination is rare, high rates of extrinsic (i. e., from in-use manipulation) contamination are present in hospitals with poor nursing standards, which predispose to bacteremia outbreaks [17,18].…”