Bacterial contamination of single- and multiple-dose vials after multiple use and intravenous admixtures in three...

Area of Science:

• Microbiology
• Hospital Pharmacy
• Infection Control

Background:

• Microbial contamination of parenteral products can lead to bloodstream infections.
• Single-dose vials (SDVs), multiple-dose vials (MDVs), and admixtures (ADXs) are susceptible during preparation and administration.
• Current practices involve preparation by nursing staff in treatment rooms or pharmacists in clean rooms.

Purpose of the Study:

• To compare microbial contamination rates of MDVs and SDVs after multiple uses.
• To evaluate contamination in ADXs prepared by nurses in treatment rooms versus pharmacists in clean rooms.
• To identify the optimal preparation environment for parenteral products to minimize infection risk.

Main Methods:

• Sterility testing of 43 opened MDVs and SDVs.
• Membrane filtration method used for 92 ADXs prepared in treatment rooms.
• Sterility assessment of 17 ADXs prepared in a clean room.

Main Results:

• One admixture (1.1%) prepared in the treatment room was contaminated with Bacillus subtilis.
• No microbial contamination was detected in ADXs prepared in the clean room.
• No contamination was found in the opened MDVs and SDVs.

Conclusions:

• Preparation of parenteral products in a clean room is the most effective strategy to prevent microbial contamination.
• While good practices can reduce risk in traditional settings, clean room preparation offers superior safety.
• Implementing clean room protocols is crucial for enhancing patient safety and preventing healthcare-associated infections.