Amábile-Cuevas CF, Lepe-Mancilla J, Muñoz-Cuevas JH

Language: Spanish
References: 13
Page: 104-110
PDF size: 143.60 Kb.

ABSTRACT

Commercially available propofol suspensions, due to their pharmaceutical composition, support the growth of several microorganisms; the administration of propofol suspensions that became microbially-contaminated after being removed from their original vial, has been linked to postsurgical infections. Addition of ethylenediaminetetracetic acid (EDTA) salts delays the growth of such microorganisms. Here, we compared the growth of seven bacterial strains and three yeast strains, along 48 hours and at three different incubation temperatures (room temperature, 35 and 42 ^oC), in four propofol formulations available in Mexico, one of them with supplemented EDTA. Consistently, microbial growth was diminished in the formulation supplemented with EDTA, compared to the other three, although with variations between microorganisms and incubation temperatures: from initial reduction in viable organisms, to complete and sustained growth inhibition, to only partial growth inhibition. While the addition of EDTA to propofol suspensions must not be considered as a substitute for aseptic handling of the drug, it certainly diminishes microbial growth that can occur after accidental contamination, reducing the infection risk for the patient.

REFERENCES

1. Li Y, Wu Y, Li R, Wang C, Jia N, Zhao C, et al. Propofol regulates the surface expression of GABAA receptors: implications in synaptic inhibition. Anesth Analg. 2015;121:1176-1183.

2. Sosis MB, Braverman B, Villaflor E. Propofol, but not thiopental, supports the growth of Candida albicans. Anesth Analg. 1995;81:132-134.

3. 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;39:509-511.

4. 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;333:147-154.

5. Hart B. ‘Diprivan’: a change of formulation. Eur J Anaesthesiol. 2000;17:71-73.

6. Thompson KA, Goodale DB. The recent development of propofol (DIPRIVAN). Intensive Care Med. 2000;26:S400-S404.

7. Fukada T, Ozaki M. Microbial growth in propofol formulations with disodium edetate and the influence of venous access system dead space. Anaesthesia. 2007;62:575-580.

8. Lozano-Noriega R, Barriga-Angulo G, Moreno-Alatorre MA, Rojas-Molina L, Castillo-Torres NP. Contaminación bacteriana extrínseca de propofol. Rev Mex Anest. 1999;22:59-67.

9. Ponce de León A, Amábile-Cuevas CF, Benítez A. In vitro activity of tigecycline and other antimicrobial drugs against selected pathogens isolated in Mexico. 18th European Congress of Clinical Microbiology and Infectious Diseases Barcelona, 2008.

10. Arredondo-García JL, Amábile-Cuevas CF; RedMic2 Study Group. Susceptibility of Mexican isolates of yeasts and moulds to amphotericin B and triazole antifungals. J Infect Dev Ctries. 2009;3:398-401.

11. Craig DB. “Preservatives” in propofol. Can J Anaesth. 1998;45:913.

12. Muñoz-Cuevas JH, de la Cruz-Pan M, Olivero-Vásquez Y. Propofol ayer y hoy. Rev Mex Anest. 2005;28:148-158.

13. Zorrilla-Vaca A, León T, Ariza F. Propofol handling practices: results from a Colombian cross-sectional study. Colombian J Anesthesiol. 2017;45:300-309.