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Microbial Growth and Endotoxin Production in the Intravenous Anesthetic Propofol

Published online by Cambridge University Press:  21 June 2016

Matthew J. Arduino ,
Lee A. Bland ,
Sigrid K. McAllister ,
Sonia M. Aguero ,
Margarita E. Villarino ,
Michael M. McNeil ,
William R. Jarvis  and
Martin S. Favero
Matthew J. Arduino
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
Lee A. Bland
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
Sigrid K. McAllister
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
Sonia M. Aguero
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
Margarita E. Villarino
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
Michael M. McNeil
Affiliation:
Division of Bacterial and Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
William R. Jarvis
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
Martin S. Favero
Affiliation:
Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia
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Abstract

Objective:

In this study, we measured microbial growth and endotoxin production in the intravenous anesthetic propofol using 10 different microbial strains; 6 isolated from outbreak cases and 4 from laboratory stock cultures.

Design:

In each trial, endotoxin-free glass tubes containing 10 ml propofol were inoculated with 10°-103 CFU/ml of the test organism and incubated at 30°C for 72 hours.

Setting:

In May and June 1990, the Centers for Disease Control received reports of 5 outbreaks in 5 states of postsurgical patient infections and/or pyrogenic reactions. Epidemiologic and laboratory investigations implicated extrinsic contamination of an intravenous anesthetic, propofol, as the probable source of these outbreaks.

Results:

After 24 hours, 9 of the 10 cultures increased in viable counts by 3 to 6 logs. At least 1 ng/ml of endotoxin was produced within 24 hours by Escherichia coli, Enterobacter cloacae, and Acinetobacter calcoaceticus subspecies anitratus.

Conclusions:

Propofol can support rapid microbial growth and endotoxin production. To avoid infectious complications, scrupulous aseptic technique should be used when preparing or administering this anesthetic.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 9 , September 1991 , pp. 535 - 539
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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