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Multiple-Dose Vials: Persistence of Bacterial Contaminants and Infection Control Implications

Published online by Cambridge University Press:  02 January 2015

Robert N. Longfield ,
L. Patrick Smith ,
Jenice N. Longfield ,
Jacqueline Coberly  and
David Cruess
Robert N. Longfield*
Affiliation:
Hospital Infection Control, Infectious Diseases Division, Department of Internal Medicine, Naval Hospital and Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
L. Patrick Smith
Affiliation:
Hospital Infection Control, Infectious Diseases Division, Department of Internal Medicine, Naval Hospital and Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Jenice N. Longfield
Affiliation:
Hospital Infection Control, Infectious Diseases Division, Department of Internal Medicine, Naval Hospital and Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Jacqueline Coberly
Affiliation:
Hospital Infection Control, Infectious Diseases Division, Department of Internal Medicine, Naval Hospital and Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
David Cruess
Affiliation:
Hospital Infection Control, Infectious Diseases Division, Department of Internal Medicine, Naval Hospital and Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
*
Infectious Diseases Division, Naval Hospital, Bethesda, MD 20814
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Abstract

Due to sporadic infections attributed to contaminated multiple-dose medication vials (MDV), some authorities have suggested discarding all MDV within 24 hours. We inoculated 11 commonly used medications with suspensions of 10 bacterial species previously associated with contaminated parenteral solutions and determined microbial persistence at both room and refrigerator temperature. At 22°C, atropine, curare, folic acid, NPH insulin and triamcinolone did not allow microbial persistence beyond 4 hours. Lidocaine and heparin were sterile by 24 hours. Regular insulin, immune serum globulin, and myochrysine allowed persistence for up to 7 days. At 4°C, bacterial persistence was significantly prolonged for all medications including those MDV requiring refrigeration. No organisms proliferated; however, F. meningosepticum and P. maltophilia were particularly persistent at both temperatures. The risk of persistent MDV contamination appears to be dependent upon specific pharmaceutical, microbe and storage temperature interactions. Recommendations for the refrigeration of MDV medications may require reevaluation on a product-by-product basis.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 5 , May 1985 , pp. 194 - 199
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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