title: Microbiological Contamination of Drugs during Their Administration for Anesthesia in the Operating Room.
abstract: BACKGROUND
  The aseptic techniques of anesthesiologists in the preparation and administration of injected medications have not been extensively investigated, but emerging data demonstrate that inadvertent lapses in aseptic technique may be an important contributor to surgical site and other postoperative infections.
  
  
  METHODS
  A prospective, open, microbiological audit of 303 cases in which anesthesiologists were asked to inject all bolus drugs, except propofol and antibiotics, through a 0.2-µm filter was performed. The authors cultured microorganisms, if present, from the 0.2-µm filter unit and from the residual contents of the syringes used for drawing up or administering drugs. Participating anesthesiologists rated ease of use of the filters after each case.
  
  
  RESULTS
  Twenty-three anesthesiologists each anesthetized up to 25 adult patients. The authors isolated microorganisms from filter units in 19 (6.3%) of 300 cases (3 cases were excluded), including Staphylococcus capitis, Staphylococcus warneri, Staphylococcus epidermidis, Staphylococcus haemolyticus, Micrococcus luteus/lylae, Corynebacterium, and Bacillus species. The authors collected used syringes at the end of each case and grew microorganisms from residual drug in 55 of these 2,318 (2.4%) syringes including all the aforementioned microorganisms and also Kocuria kristinae, Staphylococcus aureus, and Staphylococcus hominus. Participants' average rating of ease of use of the filter units was 3.5 out of 10 (0 being very easy and 10 being very difficult).
  
  
  CONCLUSIONS
  Microorganisms with the potential to cause infection are being injected (presumably inadvertently) into some patients during the administration of intravenous drugs by bolus during anesthesia. The relevance of this finding to postoperative infections warrants further investigation.
authors: From the Department of Anaesthesiology (D.A.G., S.J.M., T.G.S., J.T., C.S.W., A.F.M.), School of Pharmacy (J.S.), Department of Molecular Medicine and Pathology (S.S.), Centre for Medical and Health Sciences Education (C.S.W.), University of Auckland, Grafton, Auckland, New Zealand; and Department of Anaesthesia and Perioperative Medicine (S.J.M., T.G.S., J.T., A.F.M.), Auckland City Hospital, Grafton, Auckland, New Zealand.
authors: Derryn A
authors: DA
authors: Gargiulo
authors: Simon J
authors: SJ
authors: Mitchell
authors: Janie
authors: J
authors: Sheridan
authors: Timothy G
authors: TG
authors: Short
authors: Simon
authors: S
authors: Swift
authors: Jane
authors: J
authors: Torrie
authors: Craig S
authors: CS
authors: Webster
authors: Alan F
authors: AF
authors: Merry
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous; D001207:Asepsis; D004340:Drug Contamination / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009873:Operating Rooms; D011446:Prospective Studies
chemical_list: D018686:Anesthetics, Intravenous