Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjan.2012.10.003
Brazilian Journal of Anesthesiology
Scientific Article

Crescimento de bactérias em agentes de infusão: propofol 2% sustenta o crescimento, enquanto remifentanil e pantoprazol não

The growth of bacteria in infusion drugs: propofol 2% supports growth when remifentanil and pantoprazole do not

Ismail Aydı; n Erden; Dolunay Gülmez; Almila Gulsun Pamuk; Seda Banu Akinci; Gülş; en Hasçelik; Ulkü Aypar

http://dx.doi.org/10.1016/j.bjan.2012.10.003 Braz J Anesthesiol, vol.63, n6, p.466-472, 2013
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Resumo

EXPERIÊNCIA E OBJETIVOS: Foram avaliados os riscos da contaminação de propofol 2%, remifentanil e pantoprazol e os efeitos desses agentes in vitro no crescimento de agentes infecciosos comuns em unidades de terapia intensiva. MÉTODOS: Para a detecção do risco de contaminação, foram testados agentes preparados para uso imediato em condições de unidade de terapia intensiva. Também foram investigados os efeitos desses três agentes no crescimento bacteriano. Os agentes foram preparados nas concentrações utilizadas na unidade de terapia intensiva e inoculados com patógenos comuns; em seguida, foram incubados a 4ºC, 22ºC e 36ºC. Foram obtidas subculturas a 0, 2, 4 e 8 h e avaliadas as contagens de colônias. Foram determinados os valores de concentração inibitória mínima para todos os agentes a 4ºC, 22ºC e 36ºC. RESULTADOS: Não foi observado crescimento nos agentes preparados na unidade de terapia intensiva. Propofol tendeu a suportar o crescimento, enquanto que remifentanil inibiu o crescimento bacteriano. O efeito de pantoprazol foi variável, dependendo com a bactéria testada. Nenhum dos agentes demonstrou atividade antibacteriana nas concentrações máximas que podem ser alcançadas no sangue dos pacientes. CONCLUSÃO: Propofol sustenta vigorosamente o crescimento dos microrganismos testados, o que não ocorre com remifentanil e pantoprazol. Portanto, é importante que sejam praticadas técnicas assépticas rígidas na preparação de propofol.

Palavras-chave

Infecção nosocomial, Propofol, Remifentanil, Pantoprazol, Crescimento bacteriano

Abstract

BACKGROUND AND OBJECTIVES: Contamination risks of propofol 2%, remifentanil, and pantoprazole; and in vitro effects of these drugs on the growth of common infective agents in intensive care units were evaluated. METHODS: For detection of contamination risk, drugs were prepared ready to use under intensive care unit conditions, were tested. Effects of these three drugs on bacterial growth were also investigated. Drugs were prepared at the concentrations used in the intensive care unit and inoculated with common pathogens after which they were incubated at 4ºC, 22ºC and 36ºC. Subcultures were made at 0, 2, 4 and 8 h and colony counts were evaluated. Minimum inhibitory concentration values were determined for all drugs at 4ºC, 22ºC and 36ºC. RESULTS: o growth was observed in the drugs prepared in the intensive care unit. Propofol tended to support while remifentanil inhibited bacterial growth. Effect of pantoprozole differed according to the bacteria tested. None of the drugs showed antibacterial activity at the maximum concentrations which may be achieved in blood of the patients. CONCLUSION: Propofol strongly supports the growth of the microorganisms tested, although remifentanil and pantoprazole do not. Therefore, it is important to follow the strict aseptic techniques for the preparation of propofol.

Keywords

Nosocomial infection, Propofol, Remifentanil, Pantoprozol, Bacterial growth

References

Warren DK, Shukla SJ, Olsen MA. Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med. 2003;31:1312-7.

Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165:867-903.

Fridkin SK, Welbel SF, Weinstein RA. Magnitude and prevention of nosocomial infections in the intensive care unit. Infect Dis Clin North Am. 1997;11:479-96.

Batai I, Kerenyi M, Tekeres M. The impact of drugs used in anaesthesia on bacteria. Eur J Anaesthesiol. 1999;16:425-40.

Lessard MR, Trepanier CA, Gourdeau M. A microbiological study of the contamination of the syringes used in anaesthesia practice. Can J Anaesth. 1988;35:567-9.

Van Grafhorst JP, Foudraine NA, Nooteboom F. Unexpected high risk of contamination with staphylococci species attributable to standard preparation of syringes for continuous intravenous drug administration in a simulation model in intensive care units. Crit Care Med. 2002;30:833-6.

Özkurt Z, Altoparlak Ü, İba Yılmaz S. Reducing hospital infection rates in the burn unit by adherence to infection control measures: a six-year experience. Turk J Med Sci. 2012;42:17-24.

Geyik MF, Hoşoğlu S, Ayaz C. Surveillance of Nosocomial infections in dicle university hospital: a ten-year experience. Turk J Med Sci. 2008;38:587-93.

Apan TZ, Apan A, Sahin S. Antibacterial activity of remifentanil and mixtures of remifentanil and propofol. J Clin Anesth. 2007;19:346-50.

Nakao M, Malfertheiner P. Growth inhibitory and bactericidal activities of lansoprazole compared with those of omeprazole and pantoprazole against Helicobacter pylori. Helicobacter. 1998;3:21-7.

Aydin N, Gultekin B, Ozgun S. Bacterial contamination of propofol: the effects of temperature and lidocaine. Eur J Anaesthesiol. 2002;19:455-8.

Batai I, Kerenyi M, Tekeres M. The growth of bacteria in intravenous glyceryl trinitrate and in sodium nitroprusside. Anesth Analg. 1999;89:1570-2.

Wu C, Engler C, Norton R. Growth of Staphylococcus epidermidis in anaesthetic resuscitative drugs: implications for potential contamination. Anaesth Intensive Care. 2005;33:69-72.

Methods for Dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard. 2006.

Graystone S, Wells MF, Farrell DJ. Do intensive care drug infusions support microbial growth?. Anaesth Intensive Care. 1997;25:640-2.

Warwick JP, Blake D. Drawing up propofol. Anaesthesia. 1994;49.

Soong WA. Bacterial contamination of propofol in the operating theatre. Anaesth Intensive Care. 1999;27:493-6.

Webb SA, Roberts B, Breheny FX. Contamination of propofol infusions in the intensive care unit: incidence and clinical significance. Anaesth Intensive Care. 1998;26:162-4.

Sakuragi T, Yanagisawa K, Shirai Y. Growth of Escherichia coli in propofol, lidocaine, and mixtures of propofol and lidocaine. Acta Anaesthesiol Scand. 1999;43:476-9.

Harvey BR, Ganzberg S. Growth of microorganisms in propofol and methohexital mixtures. J Oral Maxillofac Surg. 2003;61:818-23.

Howard DPJ, Williams J, Sen S. A simple effective clean practice protocol significantly improves hand decontamination and infection control measures in the acute surgical setting. Infection. 2009;37:34-8.

Harrison CA, Rogers DW, Rosen M. Blood contamination of anaesthetic and related staff. Anaesthesia. 1990;45:831-3.

Zacher AN, Zornow MH, Evans G. Drug contamination from opening glass ampules. Anesthesiology. 1991;75:893-5.

Wachowski I, Jolly DT, Hrazdil J. The growth of microorganisms in propofol and mixtures of propofol and lidocaine. Anesth Analg. 1999;88:209-12.

Crowther J, Hrazdil J, Jolly DT. Growth of microorganisms in propofol, thiopental, and a 1:1 mixture of propofol and thiopental. Anesth Analg. 1996;82:475-8.

Bennett SN, McNeil MM, Bland LA. Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N Engl J Med. 1995;333:147-54.

Gudmundsson A, Erlendsdottir H, Gottfredsson M. Impact of pH and cationic supplementation on in vitro postantibiotic effect. Antimicrob Agents Chemother. 1991;35:2617-24.

Obayashi A, Oie S, Kamiya A. Microbial viability in preparations packaged for single use. Biol Pharm Bull. 2003;26:667-70.

Suerbaum S, Leying H, Klemm K. Antibacterial activity of pantoprazole and omeprazole against Helicobacter pylori. Eur J Clin Microbiol Infect Dis. 1991;10:92-3.

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