Evaluation of microbial contamination associated with different preparation methods for neonatal intravenous fat emulsion infusion

Catherine Herrington, Emily B. Hak, Lawrence A. Robinson, Richard Helms

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose. Microbial contamination associated with different methods of neonatal intravenous fat emulsion (IVFE) preparation and delivery was evaluated. Methods. Sterility testing was performed on IVFE dispensed via three different methods: (1) in the original container (n = 60), (2) repackaged into a syringe (n = 90), and (3) drawdown of the original container (n = 60). At the end of each infusion (24 hours for methods 1 and 3, 12 hours for method 2), a sample of the IVFE was with-drawn from the container using a sterile syringe in an International Organization for Standardization class 5 hood and sent to the hospital microbiology laboratory, where the samples were introduced into blood culture bottles and incubated for five days. Each sample was then subcultured on a blood agar plate with olive oil and left for an additional two days in a carbon dioxide incubator to assess for Malassezia furfur. Results. None of the samples from the original containers showed bacterial or fungal growth. Three of the samples from syringes had bacterial growth (two samples contained coagulase-negative staphylococcus and one contained both Klebsiella oxytoca and Citrobacter freundii), yielding a contamination rate of 3.3%. The number of contaminated samples did not significantly differ among the three preparation methods (p = 0.13). Conclusion. Repackaging IVFE into sterile syringes resulted in bacterial contamination and should be avoided in clinical practice. IVFE samples obtained using the drawdown procedure under sterile conditions for infusion over 24 hours revealed no microbial contamination.

Original languageEnglish (US)
Pages (from-to)914-918
Number of pages5
JournalAmerican Journal of Health-System Pharmacy
Volume67
Issue number11
DOIs
StatePublished - Jun 1 2010

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Intravenous Fat Emulsions
Syringes
Klebsiella oxytoca
Citrobacter freundii
Malassezia
Incubators
Hospital Laboratories
Coagulase
Growth
Microbiology
Staphylococcus
Carbon Dioxide
Infertility
Agar

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Pharmacology
  • Health Policy

Cite this

Evaluation of microbial contamination associated with different preparation methods for neonatal intravenous fat emulsion infusion. / Herrington, Catherine; Hak, Emily B.; Robinson, Lawrence A.; Helms, Richard.

In: American Journal of Health-System Pharmacy, Vol. 67, No. 11, 01.06.2010, p. 914-918.

Research output: Contribution to journalArticle

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abstract = "Purpose. Microbial contamination associated with different methods of neonatal intravenous fat emulsion (IVFE) preparation and delivery was evaluated. Methods. Sterility testing was performed on IVFE dispensed via three different methods: (1) in the original container (n = 60), (2) repackaged into a syringe (n = 90), and (3) drawdown of the original container (n = 60). At the end of each infusion (24 hours for methods 1 and 3, 12 hours for method 2), a sample of the IVFE was with-drawn from the container using a sterile syringe in an International Organization for Standardization class 5 hood and sent to the hospital microbiology laboratory, where the samples were introduced into blood culture bottles and incubated for five days. Each sample was then subcultured on a blood agar plate with olive oil and left for an additional two days in a carbon dioxide incubator to assess for Malassezia furfur. Results. None of the samples from the original containers showed bacterial or fungal growth. Three of the samples from syringes had bacterial growth (two samples contained coagulase-negative staphylococcus and one contained both Klebsiella oxytoca and Citrobacter freundii), yielding a contamination rate of 3.3{\%}. The number of contaminated samples did not significantly differ among the three preparation methods (p = 0.13). Conclusion. Repackaging IVFE into sterile syringes resulted in bacterial contamination and should be avoided in clinical practice. IVFE samples obtained using the drawdown procedure under sterile conditions for infusion over 24 hours revealed no microbial contamination.",
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