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Videographic and Microbiologic Evaluation of Eye Drop Bottle Contamination in Clinics: A Pilot Study
Ishani P Majmudar1, Harsha R Kaul1, Anushree Aneja1
1Department of Ophthalmology, Northwestern University Feinberg School of Medicine Chicago, Illinois, USA.
Background:
Many multidose eyedrops in the clinic and operating room are discarded after single use due to cross-contamination concerns. This practice contributes to significant hospital costs, drug shortages, and unnecessary greenhouse gas emissions.
Methods:
9-week, prospective, observational study of 97 patients.
Objective:
To validate the safety of multidose eyedrops in the ophthalmology clinic by ASORN-trained technicians using a videographic and microbiological analysis. Secondly, to determine optimal culturing conditions to prevent environmental contamination.
Results:
During eyedrop administration, no videos demonstrated bottle-to-patient contact. 12/96 (12.5%) plates demonstrated growth, likely due to environmental contamination. Mass spectrometry revealed non-pathogenic and common species for 8 identifiable growths. Environmental contamination is minimized by use of a biosafety cabinet.
Conclusion:
We found no clinical correlation between the use of multidose eyedrop bottles and infection on multiple patients in the ophthalmology clinic. We recommend using a biosafety cabinet to establish a national consensus for multidosing eyedrops and to improve inter-study comparisons.
Insights
Multidose eyedrops are safe for ophthalmic use, with no observed patient infections. Using a biosafety cabinet can minimize environmental contamination, supporting wider adoption of multidose eyedrop bottles.
Area of Science:
- Ophthalmology
- Infectious Disease Prevention
- Clinical Microbiology
Background:
- Multidose eyedrops are frequently discarded after single use due to cross-contamination fears.
- This practice leads to increased hospital costs, drug shortages, and environmental waste.
- Safe administration protocols are needed to reduce waste and improve resource utilization.
Purpose of the Study:
- To assess the safety of multidose eyedrops in an ophthalmology clinic setting.
- To evaluate the efficacy of ASORN-trained technicians in preventing contamination.
- To determine optimal culturing conditions to mitigate environmental contamination.
Main Methods:
- A 9-week prospective observational study involving 97 patients.
- Videographic analysis of eyedrop administration by trained technicians.
- Microbiological analysis of potential contamination using culturing and mass spectrometry.
Main Results:
- No instances of bottle-to-patient contact were observed during videographic analysis.
- 12.5% of cultures showed microbial growth, attributed to environmental contamination.
- Mass spectrometry identified non-pathogenic microorganisms, and biosafety cabinets reduced environmental contamination.
Conclusions:
- No clinical link was found between multidose eyedrop use and patient infection.
- Multidose eyedrops can be safely used in ophthalmology clinics with proper protocols.
- Implementing biosafety cabinets is recommended to establish a national consensus for multidose eyedrop use.
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