Particulate and microbial contamination in in-use admixed parenteral nutrition solutions

Shigeharu Oie1, Akira Kamiya

  • 1Department of Pharmacy, Yamaguchi University Hospital, 1-1-1 Minamikogushi, Ube 755-8505, Japan.

Insights

Particulate contamination is a significant issue in parenteral nutrition solutions, with higher particle counts found in solutions mixed with more glass ampoules. Microbial contamination was not detected.

Area of Science:

  • Pharmaceutical Science
  • Clinical Pharmacy
  • Healthcare Quality

Background:

  • Parenteral nutrition (PN) solutions are critical for patients unable to receive nutrition orally.
  • Admixing multiple drugs into PN solutions can potentially introduce contaminants.
  • Assessing contamination in in-use PN solutions is vital for patient safety.

Purpose of the Study:

  • To evaluate the levels of particulate and microbial contamination in in-use parenteral nutrition solutions.
  • To identify potential sources or contributing factors to contamination in admixed PN solutions.

Main Methods:

  • Analysis of 192 samples of in-use PN solutions from 10 hospitals.
  • Quantification of particulate contamination based on particle size (≥1.3, ≥5, ≥10, ≥50 micrometers).
  • Microbial testing for bacteria and fungi in residual solutions.

Main Results:

  • Significantly higher particulate contamination (≥1.3 micrometers) was observed in PN solutions compared to controls.
  • Increased particulate load correlated with the number of glass ampoules used in admixing.
  • No bacterial or fungal contamination was detected in any of the tested samples.

Conclusions:

  • Particulate contamination is a prevalent issue in in-use admixed PN solutions.
  • The number of glass ampoules used in admixture is a significant factor contributing to particulate contamination.
  • Implementing measures to mitigate particulate contamination in PN solutions is essential.

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