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Bacterial contamination of propofol in the operating theatre
1Department of Anaesthesia, Mater Misericordiae Hospital, Brisbane, Queensland.
Abstract:
There have been several reports of propofol becoming extrinsically contaminated with bacteria. These reports have usually related to infusions or delays in administration after the ampoule has been opened. This observational study was performed to examine bacterial contamination of propofol during usual practice in the operating theatres of a single large hospital group. One hundred samples of propofol were collected and cultured. Samples were taken immediately after administration in cases where the delay between opening the ampoule and administration was at least 15 minutes. The samples were classified according to whether the propofol was kept in the ampoule or a syringe after opening the ampoule and whether the intended use was for a single patient or multiple patients. The time between opening the ampoule and administration was recorded. There were three positive bacterial cultures. These samples all came from ampoules used for more than one patient, without the later dose (does) being drawn into a syringe at the time the ampoule was opened. This common clinical practice, especially in paediatric anaesthesia, does not comply with the manufacturer's recommendations. The clinical significance of the bacterial contamination detected is not clear. It is recommended that propofol should be handled in an aseptic fashion and measures taken to minimize the risk of bacterial contamination.
Insights
Bacterial contamination of propofol can occur, particularly when ampoules are used for multiple patients without aseptic technique. Adhering to manufacturer guidelines minimizes contamination risks during anesthesia.
Area of Science:
- Anesthesiology
- Microbiology
- Patient Safety
Background:
- Propofol contamination reports exist, often linked to infusion practices and administration delays.
- Bacterial contamination of anesthetic agents poses a risk to patient safety.
- Standard practices for propofol handling require careful consideration to prevent microbial growth.
Purpose of the Study:
- To investigate bacterial contamination of propofol in a real-world clinical setting.
- To assess propofol contamination risks associated with common handling practices in operating theatres.
- To evaluate compliance with manufacturer recommendations for propofol use.
Main Methods:
- Observational study involving 100 propofol samples from a large hospital group.
- Samples cultured after administration, focusing on cases with ≥15 minutes delay post-opening.
- Classification based on storage (ampoule vs. syringe) and patient use (single vs. multiple).
Main Results:
- Three positive bacterial cultures were identified.
- All positive cultures originated from multi-patient ampoules where subsequent doses were not drawn into a syringe upon opening.
- This practice, common in pediatric anesthesia, deviates from manufacturer guidelines.
Conclusions:
- Bacterial contamination of propofol is linked to specific handling practices, particularly multi-patient use without syringe preparation.
- Adherence to aseptic techniques and manufacturer guidelines is crucial for minimizing contamination risks.
- Further research is needed to clarify the clinical significance of detected contamination levels.