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Gadolinium-based MR contrast media: potential for growth of microbial contaminants when single vials are used for
K A Green1, B Mustachi, K Schoer
1Department of Microbiology, Mount Sinai/Princess Margaret Hospitals, Toronto, Ontario, Canada.
Objective:
To assess potential risk if single-dose vials of gadolinium-based contrast media are used for multiple patients. The use of multidose vials can pose a significant risk if contaminants are accidentally introduced into the vials and proliferate. Therefore, we tested the ability of gadolinium-based contrast to support the growth of a variety of microbial pathogens.
Materials And Methods:
We collected the unused portions of 15 single-use vials of gadolinium-based contrast media. The residual contrast material was refrigerated after use and checked for sterility prior to inoculation with a selection of gram-positive and gram-negative bacteria and yeast. Contrast material was incubated at room temperature and at 4 degrees C, and quantitative cultures were performed at 0, 24, 48, and 72 hr and at 7 days.
Results:
No microbial growth occurred from cultures of the used contrast solutions prior to inoculation. None of the organisms tested in our study proliferated in the contrast material. All test organisms persisted at least 48 hr after inoculation at both temperatures. At 7 days, Staphylococcus aureus, Streptococcus epidermidis, and Corynebacterium jeikeium were recovered in significant quantities. Colony counts of Serratia odorifera rapidly decreased at room temperature but persisted beyond 7 days at 4 degrees C.
Conclusion:
The risk of contaminating vials of contrast agents punctured aseptically is small. Our study demonstrates a lack of proliferation of organisms in the two gadolinium-based compounds tested, suggesting that these solutions could be used for more than one procedure.
Insights
Single-dose gadolinium-based contrast media vials showed no microbial proliferation, suggesting a low risk for reuse in multiple patients. This finding supports potential cost-saving measures in healthcare settings.
Area of Science:
- Microbiology
- Radiology
- Infection Control
Background:
- Multidose vials pose infection risks if contaminated.
- Single-dose vials are intended for one patient use.
- Assessing contrast media's antimicrobial properties is crucial for patient safety.
Purpose of the Study:
- To evaluate the potential for microbial growth in single-dose gadolinium-based contrast media vials.
- To determine if these contrast media support the proliferation of common microbial pathogens.
Main Methods:
- Collected residual contrast media from 15 single-use vials.
- Inoculated contrast media with gram-positive bacteria, gram-negative bacteria, and yeast.
- Performed quantitative cultures at various time points (0, 24, 48, 72 hours, and 7 days) at room temperature and 4°C.
Main Results:
- No microbial growth was observed in pre-inoculation cultures.
- No tested organisms proliferated in the gadolinium-based contrast media.
- All organisms persisted for at least 48 hours; some, like Staphylococcus aureus, Streptococcus epidermidis, and Corynebacterium jeikeium, were recovered in significant quantities at 7 days.
Conclusions:
- Gadolinium-based contrast media demonstrated a lack of organism proliferation.
- The risk of microbial contamination in aseptically punctured single-dose vials is minimal.
- Findings suggest that these contrast media solutions may be safely used for more than one procedure.