Parenteral infusions bacterial contamination in a multi-institutional survey in Mexico: Considerations for nosocomial mortality

Macías, Alejandro E.; Muñoz, Juan Manuel; Bruckner, David A.; Galván, Amparo; Rodríguez, Alma B.; Guerrero, Francisco; Medina, Humberto; Gallaga, Juan Carlos; Cortés, Gabriel

doi:10.1053/ic.1999.v27.a92879

Cited by 51 publications

(34 citation statements)

References 21 publications

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“…Though the rates of microbial contamination in in-use admixed parenteral nutrition solutions has been reported to be 0-8.2%, [8][9][10][11][12][13] it was 0% in this study. Our results support the validity of the description in the guidelines by Centers for Disease Control and Prevention (CDC), "Do not use in-line filters routinely for infection control purpose".…”

Section: Discussionmentioning

confidence: 59%

Particulate and Microbial Contamination in In-Use Admixed Parenteral Nutrition Solutions

Oie

Kamiya

2005

Biological & Pharmaceutical Bulletin

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Particulate matters such as glass particles that enter the body, being contained in infusion solutions not only cause infusion-related phlebitis but also have been suggested to damage various organs such as the lungs, brain, kidneys, liver, and spleen. [1][2][3][4] However, in Asian countries such as Japan, adequate attention is not paid to particulate contamination of parenteral solutions. For example, many drugs in glass ampoules are added to parenteral nutrition solutions, and preuse filtration is rarely performed in the preparation of parenteral nutrition solutions in the dispensary or ward. In addition, many medical institutions do not use in-line filters at the time of administration of admixed parenteral nutrition solutions. One of the reasons for the lack of adequate attention to particulate contamination of parenteral solutions may be poor recognition of this contamination because of only a few previous studies on in-use admixed parenteral nutrition solutions.5-7) Therefore, we evaluated particulate contamination of in-use admixed parenteral nutrition solutions and also microbial contamination of these solutions. MATERIALS AND METHODSWe collected residual solutions in bags of in-use parenteral nutrition solutions in 10 hospitals (215-756 beds) in Yamaguchi Prefecture, Japan, and evaluated particulate and microbial contamination in these residual solutions (total, 199 samples). Seven of the 199 samples were used as controls because they had not been mixed with ampoules or vials (unadmixed parenteral nutrition solutions).The size and number of particles were measured using a light blockage particle counter KL-04 (Rion K.K., Tokyo, Japan). In addition, the volume of the residual solution in the bag was measured. Of the 192 samples, one (50 ml residual solution) [termed admixed solution A: composition; one bag of 1700 ml sugar/electrolytes/amino acid, one vial of a vitamin complex preparation (Maltamin ® ), two glass ampoules of 1 ml/A panthol (Pantol ® ), two glass ampoules of 20 ml/A sodium chloride (Conclyte-Na ® ), two glass ampoules of 2 ml/A metoclopramide (Primperan ® ), and two glass ampoules of 10 ml/A potassium L-aspartate (Aspara K ® )] was passed through 0.22 mm membrane filters, 5 cm in diameter (Nippon Becton Dickinson Co., Tokyo, Japan), and the particles on this filter were observed and identified using a scanning electron microscope JSM-5600LV coupled to an energy dispersion spectroscope JEO-2200 (JMS, Tokyo, Japan).Microorganisms were quantified by the filter filtration method. The residual solution (5 ml) in the bag was passed through 0.22 mm membrane filters (5 cm in diameter), and 100 ml sterile physiological solution was passed through the filters to eliminate carry-overs such as sugar and amino acid on the filter. The filters were placed on Trypticase soy agar II with 5% sheep blood (Nippon Becton Dickinson Co., Tokyo, Japan) and incubated for 1-7 d at 30°C.The number of particles in residual solutions was compared according to the particle size (Ն1.3 mm, Ն5 mm, Ն10 mm, Ն50 mm) betwe...

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Section: Discussionmentioning

confidence: 59%

Particulate and Microbial Contamination in In-Use Admixed Parenteral Nutrition Solutions

Oie

Kamiya

2005

Biological & Pharmaceutical Bulletin

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“…11) In this study, none of the 234 samples showed microbial contamination. Therefore, the microbial contamination rate after admixture is estimated to be low, but further investigation is necessary.…”

Section: Discussionmentioning

confidence: 97%

Particulate and Microbial Contamination in In-Use Admixed Intravenous Infusions

Yorioka

Oie

Oomaki

et al. 2006

Biological & Pharmaceutical Bulletin

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“…Many investigations have documented outbreaks of S. liquefaciens in settings of medical care, such as hemodialysis centers and neurosurgery departments [14][15]. S. liquefaciens often colonizes hospital instruments and consumable materials that include pressure monitoring equipment, suction pumps, oxygen concentrators, mechanical ventilators, intravenous infusion sets, intravascular catheters, hand-soap dispensers, and vials of liquid medication [16][17]. Transfusion reactions associated with contaminated blood products have also been documented [18][19].…”

Section: Introductionmentioning

confidence: 99%

An outbreak of Serratia liquefaciens at a rural health center in The Gambia

Ikumapayi

Kanteh

Manneh

et al. 2016

J Infect Dev Ctries

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Introduction: Healthcare-associated infections (HAIs) are better documented in developed than in developing countries. There are emerging reports regarding the high frequency of HAIs in developing countries. We aimed to report an outbreak of an HAI caused by Serratia liquefaciens at a rural health center in The Gambia. Methodology: Following an abrupt increase in the isolation of S. liquefaciens in clinical samples, laboratory and clinical consumables, as well as staff, were screened for contamination with S. liquefaciens. Conventional microbiological techniques and biochemical identification tests were used. A phenotypic typing was achieved using the Kirby-Bauer antibiotic susceptibility method. Strategies to control the outbreak were implemented. Results: A total of 794 samples were processed during the outbreak; 44 (6%) grew S. liquefaciens. Five (25%) of the 20 suspected contaminated materials (hospital consumables and equipment) screened yielded growth of the organism. The primary source of the outbreak was hospital consumables. Three (7%) of the 44 infected children died with no other known cause than S. liquefaciens infection. Ninety-nine percent similarity of the antibiogram phenotypic typing suggests the isolates were from the same clonal origin. The outbreak was successfully controlled after the removal and sterilization of the respective contaminated fluids and equipment. Conclusions: This HAI was caused by poor practice in the preparation of medications for nebulization and intravenous infusion, hygiene practices, and a lack of awareness among staff about infection control. We recommend further studies to delineate the role played by HAIs in the developing world.

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Parenteral infusions bacterial contamination in a multi-institutional survey in Mexico: Considerations for nosocomial mortality

Cited by 51 publications

References 21 publications

Particulate and Microbial Contamination in In-Use Admixed Parenteral Nutrition Solutions

Particulate and Microbial Contamination in In-Use Admixed Parenteral Nutrition Solutions

Particulate and Microbial Contamination in In-Use Admixed Intravenous Infusions

An outbreak of Serratia liquefaciens at a rural health center in The Gambia

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