Microbial growth and endotoxin production in the intravenous anesthetic propofol.
OBJECTIVE
In this study, we measured microbial growth and endotoxin production in the intravenous anesthetic propofol using 10 different microbial strains; 6 isolated from outbreak cases and 4 from laboratory stock cultures.


METHODS
In each trial, endotoxin-free glass tubes containing 10 ml propofol were inoculated with 10(0)-10(3) CFU/ml of the test organism and incubated at 30 degrees C for 72 hours.


METHODS
In May and June 1990, the Centers for Disease Control received reports of 5 outbreaks in 5 states of postsurgical patient infections and/or pyrogenic reactions. Epidemiologic and laboratory investigations implicated extrinsic contamination of an intravenous anesthetic, propofol, as the probable source of these outbreaks.


RESULTS
After 24 hours, 9 of the 10 cultures increased in viable counts by 3 to 6 logs. At least 1 ng/ml of endotoxin was produced within 24 hours by Escherichia coli, Enterobacter cloacae, and Acinetobacter calcoaceticus subspecies anitratus.


CONCLUSIONS
Propofol can support rapid microbial growth and endotoxin production. To avoid infectious complications, scrupulous aseptic technique should be used when preparing or administering this anesthetic.
Hospital Infections Program, Centers for Disease Control, United States Department of Health and Human Services, Atlanta, Georgia.
M J
MJ
Arduino
L A
LA
Bland
S K
SK
McAllister
S M
SM
Aguero
M E
ME
Villarino
M M
MM
McNeil
W R
WR
Jarvis
M S
MS
Favero
D000771:Anesthesia, Intravenous; D001207:Asepsis / Q000379:methods / Q000592:standards; D002176:Candida albicans / Q000254:growth & development*; D004340:Drug Contamination; D004731:Endotoxins / Q000096:biosynthesis*; D006090:Gram-Negative Bacteria / Q000254:growth & development*; D006801:Humans; D015742:Propofol / Q000737:chemistry*; D013696:Temperature
D004731:Endotoxins; D015742:Propofol