Sterility of anesthetic multiple-dose vials after opening
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Abstract:
Despite the widespread use of multiple dose vials (MDV) for anesthetic medications, there is a paucity of data concerning the sterility of in-use MDV. The purpose of this study was to analyze the frequency of bacterial contamination of MDV used in current anesthesia practice. The authors collected weekly samples from 351 in-use MDV for seven consecutive weeks and cultured them using appropriate bacterial growth media. The vials contained drugs including neuromuscular blockers, anticholinergics, and an induction agent. They were sampled from locations designated for elective as well as emergency surgery. Six vial subgroups were studied with multiple samplings for 6-48 days. One-half of all opened vials remained in use after 4-9 days, while less than 5% remained after 6 weeks. No vial yielded bacteria. The authors conclude that the incidence of MDV contamination with live bacteria is low for the anesthetic medications studied. This appeared to be true even for vials with increasing duration of use and for vials from locations where emergency surgery commonly was performed.
Insights
Bacterial contamination of multiple dose vials (MDV) for anesthesia drugs is rare. This study found no bacterial growth in 351 in-use MDVs over seven weeks, even with extended use and in emergency settings.
Area of Science:
- Anesthesiology
- Microbiology
- Healthcare Infection Control
Background:
- Multiple dose vials (MDV) are frequently used for anesthetic medications.
- Limited data exists on the sterility of in-use MDVs in clinical practice.
Purpose of the Study:
- To investigate the frequency of bacterial contamination in in-use MDVs during anesthesia procedures.
- To assess the impact of duration of use and surgical setting on vial sterility.
Main Methods:
- Weekly sampling of 351 in-use MDVs containing various anesthetic drugs over seven weeks.
- Culturing of samples using appropriate bacterial growth media.
- Analysis of contamination rates based on vial usage duration (6-48 days) and surgical location (elective vs. emergency).
Main Results:
- No bacterial contamination was detected in any of the cultured MDVs.
- Vials remained in use for up to 48 days, with half used beyond 4-9 days.
- Contamination rates were low regardless of extended use or emergency surgery settings.
Conclusions:
- The incidence of bacterial contamination in in-use MDVs for studied anesthetic medications is low.
- Current practices appear to maintain vial sterility, even with prolonged use and in high-risk surgical environments.