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Published Online, 24 August 2004, www.theannals.com, DOI 10.1345/aph.1E141.
 The Annals of Pharmacotherapy: Vol. 38, No. 10, pp. 1603-1607. DOI 10.1345/aph.1E141
© 2004 Harvey Whitney Books Company.
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PEDIATRICS

Effect of 24-Hour Intravenous Tubing Set Change on the Sterility of Repackaged Fat Emulsion in Neonates

Pamela D Reiter, PharmD

Pediatric Clinical Pharmacy Specialist, Adjoint Assistant Professor, The Children's Hospital; School of Pharmacy, Department of Pharmacy and University of Colorado Health Sciences Center, Denver, Co

Janie Robles, PharmD

Pediatric Specialty Pharmacy Resident, Department of Pharmacy, The Children's Hospital, Denver

Elaine B Dowell, SM ASCP

Technical Supervisor Microbiology, Department of Pathology, The Children's Hospital, Denver

Reprints: Pamela D Reiter PharmD, Department of Pharmacy, The Children's Hospital, Campus Box B375, 1056 E. 19th Ave., Denver, CO 80218-1068, fax 303/837-2817, reiter.pam{at}tchden.org

BACKGROUND: Duration of intravenous fat emulsion (IVFE) infusions, precise method of administration (manufactured bottle vs repackaged syringe), and interval for administration set change continue to be debated.

OBJECTIVE: To determine the contamination rate associated with replacing IVFE administration sets every 24 hours in newborn infants receiving fat emulsion repackaged into unit-of-use syringes.

METHODS: This was a prospective, microbiologic study of 90 administration sets used in 19 neonates. IVFE samples were obtained from administration sets at the end of a 19- to 23-hour infusion and prior to daily tubing set change from infants who received repackaged IVFE. Samples of IVFE (1–3 mL) were aseptically removed at the catheter connection site proximal to the patient, transferred into BACTEC PEDSPlus culture media, and continuously monitored for 5 days to detect gram-positive and gram-negative organisms, as well as yeast.

RESULTS: Two samples (2.27%) grew coagulase-negative Staphylococcus. Both samples were from the same asymptomatic patient and were obtained on consecutive days. A blood sample obtained through this infant's central catheter grew the same organism and suggested catheter hub colonization as the primary site of microbe origin.

CONCLUSIONS: Microbial contamination of IVFE infusion sets changed at 24-hour intervals, using unit-of-use syringes in neonates, was low at 2.2%.

Key Words: intravenous fat emulsion, sterility, syringe

Published Online, August 24, 2004. www.theannals.com, DOI 10.1345/aph.1E141




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