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Propofol emulsion and bacterial contamination

Abstract

Package insert information provided with propofol advises prompt administration following its drawing-up. This study has examined the delays which occur between drawing-up and administration of propofol in clinical practice and the incidence of bacterial contamination occurring under such conditions. Two hundred and fifty-four clinical uses of propofol were examined. Mean elapsed times (range) from drawing-up to induction were 28.8 min (1–172), and 11.6 min (1–65) from induction to culture inoculation. The delay to induction exceeded ten minutes in 68.5% of propofol uses. Sixteen cultures (6.3%) grew bacteria. Delay to induction was not associated with increased chances of bacterial growth in any of the samples. Increasing delay between induction and culture inoculation was associated with greater odds of bacterial growth, which is consistent with contamination occurring at or after induction. Whilst the manufacturers advise prompt administration, our findings show that when inadvertent delays occur, propofol remains bacteriologically safe to use under standard clinical conditions. Microbial contamination can occur at any stage, thus attention to asepsis remains important throughout the administration period.

Résumé

Le dépliant inséré dans l’emballage du propofol met en garde contre les délais d’administration une fois le produit soutiré. Cette étude porte sur les délais enregistrés entre l’aspiration du propofol et son administration en clinique, et l’incidence de la contamination bactérienne dans ces conditions. Deux cent cinquante-quatre maniements sont étudiés. Les délais entre le soutirage et l’administration sont de 28,8 min (1–172) et de 11,6 min (1–65) entre l’induction et la culture. Le délai jusqu’à l’induction dépasse dix minutes dans 68,5% des maniements. tDes bactéries se développent 16 fois dans les milieux de cultures (6,3%). Le délai jusqu’à l’induction n’est pas associé à une plus grande probabilité de croissance bactérienne, ce qui est cohérent avec la contamination qui survient à l’induction ou après celleci. Même si les manufacturiers avertissent d’utiliser le propofol sans délai, notre travail montre que lorsque des délai imprévisibles surviennent, le propofol demeure stérile sous des conditions cliniques standards. La contamination bactérienne étant possible à tous les stages du maniement, il est important de maintenir l’asepsie pendant toute la période d’administration.

References

  1. 1

    White PF, Watcha MF. The practice of anesthesiology and the package insert: decision-making regarding drug use in anesthesiology. Anesth Analg 1993; 76: 928–30.

  2. 2

    Deitel M, Kaminsky VM, Fuska M. Growth of common bacteria and Candida albicans in 10% soybean oil emulsion. Can J Surg 1975; 18: 531–5.

  3. 3

    Deitel M, Fuska M, Kaminsky VM, Vasic V. Growth of micro-organisms in soybean oil emulsion and clinical implications. Int Surg 1979; 64: 27–32.

  4. 4

    Keammerer D, Mayhall CG, Hall GO, Pesko LJ, Thomas RB. Microbial growth patterns in intravenous fat emulsions. Am J Hosp Pharm 1983; 40: 1650–3.

  5. 5

    Garcia-Cabellero J, Herruzo-Cabrera H, Vera-Cortes ML, et al. The growth of micro-organisms in intravenous fluids. J Hosp Infect 1985; 6: 154–7.

  6. 6

    Arduino MJ, Bland LA, McAlister SK, et al. Microbial growth and endotoxin production in the intravenous anesthetic propofol. Infect Control Hosp Epidemiol 1991; 12: 535–9.

  7. 7

    Tessler M, Dascal A, Gioseffini S, Miller M, Mendelson J. Growth curves of Staphylococcus aureus, Candida albicans, and Moraxella osloensis in propofol and other media. Can J Anaesth 1992; 39: 509–11.

  8. 8

    Berry CB, Gillespie T, Hood J, Scott NB. Growth of micro-organisms in solutions of intravenous anaesthetic agents. Anaesthesia 1993; 48: 30–2.

  9. 9

    Sosis MB, Braverman B. Growth of Staphylococcus aureus in four intravenous anesthetics. Anesth Analg 1993; 77: 766–8.

  10. 10

    Downs GJ, Haley PR, Parent JB. Propofol: can a single ampule be used for multiple patients? (Letter). Anesthesiology 1991; 74: 1156.

  11. 11

    Goodale DB. Propofol: can a single ampule be used for multiple patients? (Letter). Anesthesiology 1991; 74: 1156–7.

  12. 12

    McLeod GA, Pace N, Inglis MD. Bacterial growth in propofol (Letter). Br J Anaesth 1991; 67: 665–6.

  13. 13

    Center for Disease Control. Postsurgical infections associated with extrinsically contaminated intravenous anesthetic agent —California, Illinois, Maine, and Michigan. MMWR Morb Mortal Wkly Rep 1990; 39: 426–7,433.

  14. 14

    Veber B, Gachot B, Bedos JP, Wolff M. Severe sepsis after intravenous injection of contaminated propofol. (Letter). Anesthesiology 1994; 80: 712.

  15. 15

    Oberhammer EP. Contamination of injection ports on intravenous cannula (Letter). Lancet 1980; 2: 1027–8.

  16. 16

    Cheesborough JS, Finch R. Side-ports —an infection hazard? British Journal of Parenteral Therapy 1984; 155–7.

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Author information

Correspondence to Gerard J. McHugh.

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McHugh, G.J., Roper, G.M. Propofol emulsion and bacterial contamination. Can J Anaesth 42, 801 (1995). https://doi.org/10.1007/BF03011181

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Key words

  • anaesthetics, intravenous: propofol
  • complications: bacterial contamination