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Microbial contamination of single- and multiple-dose vials after opening in a pulmonary teaching hospital
Shadi Baniasadi1, Atosa Dorudinia, Mandana Mobarhan
1Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran. sbaniasadi@yahoo.com
Objectives:
Intravenous therapy is a complex procedure usually requiring the preparation of the medication in the clinical area before administration to the patient. Breaches in aseptic technique may result in microbial contaminations of vials which is a potential cause of different avoidable infections. We aimed to investigate the prevalence and pattern of microbial contamination of single- and multiple-dose vials in the largest pulmonary teaching hospital in Iran.
Methods:
In a period of 2 months, opened single- and multiple-dose vials from different wards were sampled by a pharmacist. The name of the medication, ward, labeling of the vials, the date of opening, and storing temperature were recorded for each vial. Remained contents of each vial were cultured using appropriate bacterial and fungal growth media.
Results:
Microbial contamination was identified in 11 of 205 (5.36%) of vials. The highest contamination rate was 14.28% for vials used in interventional bronchoscopy unit. The most frequent contaminated medication was insulin. Gram-positive bacteria (81.82%) were more significantly involved than gram-negative ones (9.09%) and fungi (9.09%), with the highest frequency for Staphylococcus epidermidis.
Conclusions:
Our data demonstrate that repeated use of vials especially if basic sterility measures are disobeyed can cause microbial contamination of administered products to the patients. Infection preventionists are responsible to train health care workers regarding aseptic techniques and apply guidelines for aseptic handling of intravenous solutions.
Insights
Microbial contamination of medication vials occurred in 5.36% of cases, with insulin vials in the bronchoscopy unit being most affected. Adhering to aseptic techniques is crucial to prevent patient infections from contaminated intravenous products.
Area of Science:
- Microbiology
- Infection Prevention
- Hospital Pharmacy
Background:
- Intravenous (IV) therapy requires medication preparation, posing risks of microbial contamination.
- Aseptic technique breaches during vial handling can lead to preventable patient infections.
Purpose of the Study:
- To determine the prevalence and patterns of microbial contamination in single- and multiple-dose vials.
- To investigate vial contamination in Iran's largest pulmonary teaching hospital.
Main Methods:
- Pharmacists sampled opened vials from various hospital wards over two months.
- Data collected included medication type, ward, labeling, opening date, and storage temperature.
- Vial contents underwent bacterial and fungal culture.
Main Results:
- 11 out of 205 vials (5.36%) showed microbial contamination.
- The highest contamination rate (14.28%) was observed in vials from the interventional bronchoscopy unit.
- Insulin was the most frequently contaminated medication, with Gram-positive bacteria, particularly Staphylococcus epidermidis, being the most common contaminants.
Conclusions:
- Repeated vial use, especially with compromised sterility, can lead to microbial contamination of patient-administered products.
- Infection preventionists must train healthcare workers on aseptic techniques and enforce guidelines for handling intravenous solutions.
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