Effect of 24-hour intravenous tubing set change on the sterility of repackaged fat emulsion in neonates.
BACKGROUND
Duration of intravenous fat emulsion (IVFE) infusions, precise method of administration (manufactured bottle vs repackaged syringe), and interval for administration set change continue to be debated.


OBJECTIVE
To determine the contamination rate associated with replacing IVFE administration sets every 24 hours in newborn infants receiving fat emulsion repackaged into unit-of-use syringes.


METHODS
This was a prospective, microbiologic study of 90 administration sets used in 19 neonates. IVFE samples were obtained from administration sets at the end of a 19- to 23-hour infusion and prior to daily tubing set change from infants who received repackaged IVFE. Samples of IVFE (1-3 mL) were aseptically removed at the catheter connection site proximal to the patient, transferred into BACTEC PEDSPlus culture media, and continuously monitored for 5 days to detect gram-positive and gram-negative organisms, as well as yeast.


RESULTS
Two samples (2.27%) grew coagulase-negative Staphylococcus. Both samples were from the same asymptomatic patient and were obtained on consecutive days. A blood sample obtained through this infant's central catheter grew the same organism and suggested catheter hub colonization as the primary site of microbe origin.


CONCLUSIONS
Microbial contamination of IVFE infusion sets changed at 24-hour intervals, using unit-of-use syringes in neonates, was low at 2.2%.
Reiter
Pamela D
PD
The Children's Hospital, School of Pharmacy, Department of Pharmacy and University of Colorado Health Sciences Center, Denver, CO, USA. reiter.pam@tchden.org
Robles
Janie
J
Dowell
Elaine B
EB
D004340:Drug Contamination / Q000517:prevention & control; D004866:Equipment Contamination / Q000517:prevention & control; D004864:Equipment and Supplies / Q000382:microbiology*; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous / Q000295:instrumentation; D011446:Prospective Studies; D011786:Quality Control; D013210:Staphylococcus / Q000302:isolation & purification; D013997:Time Factors
D005217:Fat Emulsions, Intravenous