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Multiple Sterile Withdrawals from Iohexol Bottles Does Not Increase Contamination Risk.

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Global iohexol contrast media shortages due to COVID-19 necessitate resource conservation. This study found that multiple sterile withdrawals from iohexol bottles do not increase contamination risk, suggesting safe reuse of single-use vials.

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Area of Science:

  • Radiology
  • Infectious Disease
  • Healthcare Management

Background:

  • Global shortage of iohexol contrast media impacts epidural injections.
  • COVID-19 related production decreases and lockdowns exacerbate the scarcity.
  • Single-use iohexol bottles lead to significant waste (up to 95%).

Purpose of the Study:

  • To determine if multiple sterile withdrawals from iohexol bottles increase contamination risk compared to single withdrawals.
  • To assess the survival and growth of bacteria within iohexol contrast media.

Main Methods:

  • Experimental study involving 21 iohexol bottles tested after first and last withdrawals.
  • Bacterial and fungal cultures and 3M™ Petrifilms™ used for specimen testing.
  • Methicillin-susceptible Staphylococcus aureus (MSSA) survival/growth assessed in varying iohexol concentrations.

Main Results:

  • No bacterial or fungal growth was observed in cultures or on Petrifilms from any withdrawal.
  • A significant decrease in bacterial counts was noted as iohexol concentration increased.
  • MSSA showed reduced survival/growth in higher concentrations of iohexol contrast media.

Conclusions:

  • Results suggest that single-use iohexol bottles may be safely reused.
  • The contrast media exhibits mild antimicrobial properties.
  • Reusing iohexol bottles can conserve resources and reduce healthcare costs during shortages.