Iatrogenic contamination of multidose vials in simulated use. A reassessment of current patient injection technique

Plott, R. T.

doi:10.1001/archderm.126.11.1441

Cited by 19 publications

(17 citation statements)

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“…There are reports of cross-infection with Plasmodium falciparum malaria, that show the possibility of crossinfection between MDVs [12] probably from multiple use of vials with heparin and sodium chloride 0.9% for flushing intravenous lines [10,11]. Results of a survey were the reason for altering the guidelines on the use of parenteral drugs in the UK: "Drugs for single use are not to be used more than once or in more than one patient, and multidose preparations are each to be used in only one patient" [13].…”

Section: Discussionmentioning

confidence: 99%

Bacterial contamination of solutions for parenteral administration for single- and multiple-dose vials after multiple use in the hospital

Nogler-Semenitz

Lass‐Flörl

Nogler

et al. 2007

Wien Med Wochenschr

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Outbreaks traced to bacterial contamination of multiple-dose vials are reported in the literature. During a four-month period, multi-dose vials (MDVs), single-dose vials (SDVs), and vials containing self-prepared admixtures were collected from various wards to analyse sterility of their contents. We examined 68 commercially available MDVs containing sodium chloride 0.9% or heparin with added preservative and 17 single dose vials (SDVs) containing aqua ad injectionem or sodium chloride 0.9% and 11 vials with admixtures (ADX) of heparin and sodium chloride 0.9%, both without preservative. Four of 96 (4.17%) vials were not sterile: two of them were contaminated with spore-forming bacteria, two with coagulase negative Staphylococci. Three of the samples were MDVs containing a preservative. The date of the first use was not marked on 28% of the vials. Twenty-eight samples were multiply used, although they were SDVs or ADXs without preservative or without an adequate amount of preservative, respectively. In 15 of 68 MDVs, the time limit after the first use was exceeded. On average, the volume of the samples was 80% of the original volume. A proportion of 4% of vials was not sterile. A training programme for health care workers in aseptic techniques and for validation of the preparation of solutions for parenteral use should be installed.

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Section: Discussionmentioning

confidence: 99%

Bacterial contamination of solutions for parenteral administration for single- and multiple-dose vials after multiple use in the hospital

Nogler-Semenitz

Lass‐Flörl

Nogler

et al. 2007

Wien Med Wochenschr

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“…Unresolved issue X. IV-injection ports A. Clean injection ports with 70% alcohol or an iodophor before accessing the system [164,235,236]. Category IA B.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

“…Category IA 3. Use a sterile device to access a multidose vial and avoid touch contamination of the device before penetrating the access diaphragm [235,240]. Category IA 4.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

635

843

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These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

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“…Die Einhaltung streng aseptischer Techniken ist bei der Benutzung von Mehrdosisbehältern unabdingbar. Empfohlen werden die Wischdesinfektion des Gummistopfens vor Punktion[215], die Verwendung einer neuen Nadel und Spritze bei jeder Punktion[215,216,217] oder die Verwendung von Mehrfachentnahmekanü-len mit Luftfilter, Kontaminationsschutzhülle und Verschlusskappe[218]. Das alleinige Wechseln der Nadel bei Weiterverwendung einer benutzten Spritze kann zu einer Kontamination des Mehrdosisbehälters führen[214,217].…”

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“…Empfohlen werden die Wischdesinfektion des Gummistopfens vor Punktion[215], die Verwendung einer neuen Nadel und Spritze bei jeder Punktion[215,216,217] oder die Verwendung von Mehrfachentnahmekanü-len mit Luftfilter, Kontaminationsschutzhülle und Verschlusskappe[218]. Das alleinige Wechseln der Nadel bei Weiterverwendung einer benutzten Spritze kann zu einer Kontamination des Mehrdosisbehälters führen[214,217]. Auf angebrochenen Mehrdosisbehältern müssen Anbruchdatum unduhrzeit notiert werden[219]; bezüglich der Verwendungszeiten und Lagerungsbedingungen sind die Herstellerangaben zu befolgen.…”

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Prävention Gefäßkatheterassoziierter Infektionen

Available¹

2002

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschu

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Iatrogenic contamination of multidose vials in simulated use. A reassessment of current patient injection technique

Cited by 19 publications

References 0 publications

Bacterial contamination of solutions for parenteral administration for single- and multiple-dose vials after multiple use in the hospital

Bacterial contamination of solutions for parenteral administration for single- and multiple-dose vials after multiple use in the hospital

Guidelines for the prevention of intravascular catheter-related infections

Prävention Gefäßkatheterassoziierter Infektionen

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