Department of Kidney services, Logan hospital, Meadowbrook, QLD, Australia.
School of Medicine, University of Queensland, Australia.
Perit Dial Int. 2024 Nov;44(6):434-437. doi: 10.1177/08968608231213736. Epub 2023 Dec 19.
Intraperitoneal antibiotics may be required daily for up to three weeks to treat peritoneal dialysis (PD)-related peritonitis. In some jurisdictions, antibiotic-admixed PD solutions are required to be used within 24 h due to concerns regarding microbial contamination and growth. This requires patients to attend the PD unit daily or alternatively for staff to perform home delivery with associated transport, staffing and cost implications.
The aim of this study was to determine if significant microbial growth occurs in PD solutions following their injection with antibiotic or sterile water.
Twelve PD solution bags were admixed with cefazolin sodium 1 g, diluted in 10 mL sterile water, while a further 12 PD solution bags were admixed with 10 mL sterile water using aseptic technique (AT) under supervision. All bags were stored at room temperature. Three bags from each experimental group were sampled for microbiologic culture at 0-, 24-, 48- and 72-h intervals.
One sterile water admixed bag sampled at 24 h yielded a . after microbiologic culture. A repeat specimen from the same bag at day nine returned a negative culture result. All other sterile water and cefazolin admixed bags returned negative culture results at all time points.
Antibiotic-admixed PD solutions prepared using AT and stored at room temperature remained sterile for up to 72 h. This suggests that patients can be safely issued with a supply of antibiotic-admixed PD bags for up to three days at a time.
腹腔内抗生素可能需要每天使用长达三周的时间来治疗腹膜透析（PD）相关腹膜炎。在某些司法管辖区，由于担心微生物污染和生长，混合抗生素的 PD 溶液需要在 24 小时内使用。这要求患者每天到 PD 单位就诊，或者由工作人员进行家庭配送，并带来相关的交通、人员配备和成本问题。
本研究旨在确定 PD 溶液在注入抗生素或无菌水后是否会发生明显的微生物生长。
将 12 袋 PD 溶液与头孢唑林钠 1 克混合，用 10 毫升无菌水稀释，同时用无菌技术（AT）将另外 12 袋 PD 溶液与 10 毫升无菌水混合，在监督下进行。所有袋子均在室温下储存。从每个实验组中抽取三个袋子，在 0、24、48 和 72 小时的时间点进行微生物培养取样。
在 24 小时时，对 1 个混合无菌水的袋子进行微生物培养，结果为阳性。来自同一袋子的重复样本在第 9 天返回阴性培养结果。所有其他无菌水和头孢唑林混合袋在所有时间点均返回阴性培养结果。
使用 AT 制备并在室温下储存的混合抗生素的 PD 溶液在 72 小时内保持无菌。这表明患者可以安全地一次性配发长达三天的混合抗生素 PD 袋。
