Longfield R N, Smith L P, Longfield J N, Coberly J, Cruess D
Infect Control. 1985 May;6(5):194-9. doi: 10.1017/s0195941700061415.
Due to sporadic infections attributed to contaminated multiple-dose medication vials (MDV), some authorities have suggested discarding all MDV within 24 hours. We inoculated 11 commonly used medications with suspensions of 10 bacterial species previously associated with contaminated parenteral solutions and determined microbial persistence at both room and refrigerator temperature. At 22 degrees C, atropine, curare, folic acid, NPH insulin and triamcinolone did not allow microbial persistence beyond 4 hours. Lidocaine and heparin were sterile by 24 hours. Regular insulin, immune serum globulin, and myochrysine allowed persistence for up to 7 days. At 4 degrees C, bacterial persistence was significantly prolonged for all medications including those MDV requiring refrigeration. No organisms proliferated; however, F. meningosepticum and P. maltophilia were particularly persistent at both temperatures. The risk of persistent MDV contamination appears to be dependent upon specific pharmaceutical, microbe and storage temperature interactions. Recommendations for the refrigeration of MDV medications may require reevaluation on a product-by-product basis.
由于多剂量药瓶（MDV）受污染导致的散发性感染，一些权威机构建议在24小时内丢弃所有MDV。我们用先前与污染的肠胃外溶液相关的10种细菌的悬浮液接种了11种常用药物，并在室温和冰箱温度下测定了微生物的存活情况。在22摄氏度时，阿托品、箭毒、叶酸、NPH胰岛素和曲安奈德在4小时后不允许微生物存活。利多卡因和肝素在24小时后无菌。普通胰岛素、免疫血清球蛋白和硫代苹果酸金钠允许存活长达7天。在4摄氏度时，所有药物包括那些需要冷藏的MDV的细菌存活时间都显著延长。没有微生物增殖；然而，嗜水气单胞菌和嗜麦芽窄食单胞菌在这两个温度下都特别持久。MDV持续污染的风险似乎取决于特定药物、微生物和储存温度之间的相互作用。关于MDV药物冷藏的建议可能需要逐产品重新评估。
