The prevalence of multidose vial contamination by aerobic bacteria in a major teaching hospital, Shiraz, Iran, 2006

Background

Parenteral medications are usually given out in multidose vials (MDVs) and can be used for a prolonged period for 1 or more patients. The risk of extrinsic contamination of MDVs and its consequences may be serious and may lead to an outbreak, especially in hospitals. Therefore, bacterial contamination of multiple-dose medication vials in Namazi Hospital, the major referral teaching hospital, in Shiraz, southwestern Iran, was evaluated.

Methods

In a period of 4 months, all used MDVs in Namazi Hospital were collected by the infection control nurses. Information was recorded about the medication, labeling of vials, storing temperature, wards, and dates of opening. Remained contents of each vial were also tested for aerobic bacteria. Microbial contamination was confirmed by microbiologic methods.

Results

Bacterial contamination was identified in 36 of 637 (5.6%) of vials, with no difference in contamination among different wards in the hospital or the medication type. Most commonly identified organisms were part of the normal commensally flora. Gram-positive bacteria (88.9%) were more significantly involved than gram-negative ones (11.1%), with the highest frequency for Staphylococcus epidermidis (44.4%) and the lowest for Actinomyces viscosus (2.8%).

Conclusion

Although the clinical significance is not resolved at this point, infection control practices should be emphasized considering this potential source of nosocomial infection.