Infante VV, Cano AM, Medina VH , Macías AE, Álvarez JA

Language: Spanish
References: 28
Page: 120-125
PDF size: 197.29 Kb.

ABSTRACT

Introduction. Nutrient-containing aqueous solutions for parenteral use are susceptible of microbial contamination, beeing an important cause of serious infectious complications. Objective. To determine the capacity of organisms for growing in saline as compared with dextrose solution and tridestilled sterile water. Material and methods. Experimental controlled study. Different microbial strains were innoculated in aqueous solutions (5% dextrose and 0.9% saline) as well as tri-destilled sterile water. Results were analized using the ANOVA test for repeated measurements. Results. In 0.9% saline solution, all the Enterobacteriaceae strains tested had a significant increase in their bacterial quantification in the analized time period (F = 8.35, p = 0.0145). For most organisms, the growth was even better than the one observed in nutrient-containing solution. Conclusions. The 0.9% saline solution can support significative growing of potentially pathogenic bacteria. We recommend a strict compliance to the good nursing standards when handling this kind of solutions.

REFERENCES

1. Maki DG, Martin WT. Nationwide epidemic of septicemia caused by contaminated infusion products. IV. Growth of microbial pathogens in fluids for intravenous infusion. J Infect Dis 1975; 131: 267-72.

2. Macias AE, Bruckner DA, Hindler JA, Muñoz JM, Medina H, Hernandez I, et al. Parenteral infusions as culture media from a viewpoint of nosocomial bacteremia. Rev Invest Clin 2000; 52: 39-43.

3. Bennett SN, McNeil MM, Bland LA, Arduino MJ, Villarino ME, Perrotta DM, et al. Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N Engl J Med 1995; 333: 147-54.

4. Maki DG, Rhame FS, Mackel JV. Nationwide epidemic of septicemia caused by contaminated intravenous products. I. Epidemiologic and clinical features. Am J Med 1976; 60: 471-85.

5. Maki DG. Infections due to infusion therapy. In: Bennet JV, Brachman PS, Sanford JP (eds.). Hospital infections. 3th Ed. Boston: Little, Brown and Company; 1992, p. 849-92.

6. Band JD, Maki DG. Safety of changing intravenous delivery systems at longer than 24-hours intervals. Ann Intern Med 1979; 91: 173-8.

7. Buxton AE, Highsmith AK, Garner JS, et al. Contamination of intravenous fluid: Effects of changing administration sets. Ann Intern Med 1979; 90: 764-8.

8. Gorbea HF, Snydman DR, Delaney A, Stockman J, Martin WJ. Intravenous tubing with burettes can be safely changed at 48- hours intervals. JAMA 1984; 251: 2112-5.

9. Josephson A, Gomberth ME, Sierra MF, et al. The relationship between intravenous fluid contamination and frequency of tubing replacement. Infect Control 1985; 6: 367-70.

10. Maki DG, Botticelli JT, LeRoy ML, Thielke TS. Prospective study of replacing administration sets for intravenous therapy at 48- vs. 72-hours intervals. JAMA 1987; 258: 1777-81.

11. Snydman DR. Reidy MD, Perry LK, Martin WJ. Safety of changing intravenous (IV) administration sets containing burettes at longer than 48 hours intervals. Infect Control 1987; 8: 113-6.

12. Hernández Ramos MA, Gaytan Meza J, Romero D, Hernández M, Ávila C. Contaminación de soluciones parenterales en pediatría. Enf Infec Microbiol 1998; 18: 100-01.

13. Macías AE, Muñoz JM, Bruckner DA, Galván A, Rodríguez AB, Guerrero FJ, et al. Parenteral infusions bacterial contamination in a multi-institutional survey in Mexico: Considerations for nosocomial mortality. Am J Infect Control 1999; 27: 285- 90.

14. Macías-Hernández AE, Ortega-González P, Muñoz Barret JM, et al. Pediatric nosocomial bacteremia. Culturing infusion liquids may help in its control. Rev Invest Clin 1994; 46: 295-300.

15. Macías-Hernández AE, Hernández-Ramos I, Muñoz Barret JM, et al. Pediatric primary gram-negative bacteremia: A possible relationship with infusate contamination. Infect Control Hosp Epidemiol 1996; 17: 276-80.

16. Weil DC, Arnow PM. Safety of refrigerated storage of admixed parenteral fluids. J Clin microbiol 1998; 26: 1787-90.

17. Crichton EP. Infusion fluids as culture media. Am J Clin Pathol 1973; 59: 199-202.

18. Felts SK, Schaffner W, Melly A, Koening MG. Sepsis caused by contaminated intravenous fluids. Epidemiological, clinical and laboratory investigation of an outbreak in one hospital. Ann Intern Med 1972; 77: 881-90.

19. Gelbart SM, Reinhardt GF, Greenlee HB. Multiplication of nosocomial pathogens in intravenous feeding solutions. Appl Microbiol 1973; 26: 874-9.

20. Guynn JB, Poretz DM, Diuma RJ. Growth of various bacteria in a variety of intravenous fluids. Am J Hosp Pharm 1973; 30: 321-5.

21. Hugbo PG, Imhanlahimi WAA. Growth of bacteria in intravenous fluids under simulated actual-use conditions. Am J Hosp Pharm 1983; 40: 998-1001.

22. Michael L, Ruebner B. Growth of bacteria in intravenous infusion fluids. Lancet 1953; i: 772-4.

23. Sweeney DF, Willcox MD, Sansey N, Leitch C, Harmis N, Wong R, Holden BA. Incidence of contamination of preserved saline solutions during normal use. CLAO J 1999; 25: 167-75.

24. Klimpel D, Cohon MS. pH of intravenous solutions. N Engl J Med 1969; 280(16): 900-01.

25. Macías AE, Munoz JM, Herrera LE, Medina H, Hernández I, Alcántar D, et al. Nosocomial pediatric bacteremia: The role of intravenous set contamination in developing countries. Infect Control Hosp Epidemiol 2004; 25: 189-9.

26. Pegues DA, Arathoon EG, Samayoa B, Del Valle GT, Anderson RL, Riddle CF, et al. Epidemic gram-negative bacteriemia in a neonatal unit in Guatemala. Am J Infect Control 1994; 22: 163-71.

27. Mosqueda JL, Álvarez JA, Muñoz JM, Alpuche C, Ponce-de- León S, Córdova JA. Análisis de las bacteriemias nosocomiales pediátricas en un hospital general entre 1990 y 2006. Impacto de la atención a la terapia intravascular. Rev Invest Clin 2010; 62: 503-08.

28. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725-32.