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Volume 22, Number 6—June 2016
CME ACTIVITY - Synopsis

Infectious Disease Risk Associated with Contaminated Propofol Anesthesia, 1989–20141

Andrés Zorrilla-VacaComments to Author , Jimmy J. Arevalo, Kevin Escandón-Vargas, Daniel Soltanifar, and Marek A. Mirski
Author affiliations: Universidad del Valle School of Medicine, Cali, Colombia (A. Zorrilla-Vaca, K. Escandón-Vargas); Fundación Universitaria de Ciencias de la Salud, Bogota, Colombia (J.J. Arevalo); Royal Free Hospital, London, United Kingdom (D. Soltanifar); Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (M.A. Mirski)

Main Article

Table 3

Summary of studies of syringes, vials, infusion lines, and IV stopcock dead spaces for contamination after clinical use to administer propofol anesthesia*

Object† and study, year (reference) Country Antimicrobial agents‡ Hospital unit§ Crude % contaminated propofol (no. contaminated/no. tested)
Syringes
Farrington et al., 1994 (31) United Kingdom No ICU 6.0 (3/50)
Bach et al., 1997 (30) Germany No OR 4.8 (8/168),¶ 5.1 (19/376)#
Webb et al., 1998 (23) Australia ND ICU 5.9 (18/302)
Total
5.4 (48/896)**
Vials
McHugh et al., 1995 (25) New Zealand No OR 6.3 (16/254)
Soong et al., 1999 (24) Australia ND OR 3.0 (3/100)
Zorrilla-Vaca et al., 2014 (32) Colombia No OR 6.1 (12/198)
Total
5.6 (31/552)**
Infusion systems
Bach et al., 1997 (30) Germany No ICU 4.5 (10/224),¶ 1.6 (5/318)#
Lorenz et al., 2002 (26) Austria No OR 11.3 (9/80),†† 8.8 (7/80)‡‡
Total
4.4 (31/702)**
IV stopcock dead spaces
Cole et al., 2013 (27) United States Yes OR 17.3 (26/150)

*ICU, intensive care unit; OR, operating room; ND, not described in publication; IV, intravenous.
†Clinical object from which residual propofol was taken to be cultured after clinical use.
‡Use of propofol formulations with antimicrobial additives.
§Hospital unit where the studies were conducted.
¶Results of a first study period during February 1­–October 31, 1992.
#Results of a second study-period from December 1, 1994, through March 31, 1995.
**Total crude percentage of contaminated propofol for each kind of object (syringes, vials, infusion systems).
††Proportion of propofol contaminated, following the manufacturer’s handling recommendations.
‡‡Proportion of propofol contaminated, following a modified propofol handling protocol. (i.e., refilling empty syringes and renewing only the infusion line to the patient).

Main Article

1Part of this work was presented at the XXXI Colombian Congress of Anesthesiology and Critical Care, Cali, Columbia, July 2015.

Page created: May 11, 2016
Page updated: May 11, 2016
Page reviewed: May 11, 2016
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