International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 16 , ISSUE 5 ( September-October, 2023 ) > List of Articles

ORIGINAL RESEARCH

Screening for Microbial Contamination of Multi-dose Lignocaine Vials in a Dental Hospital: A Prospective Study

Swathi Manohar Renu, Ashwin P Rao, Dhanashree Biranthabail, Karuna Yarmuja Mahabala, Anupama Nayak Panakaje

Keywords : Bacterial contamination, Fungal contamination, Lignocaine, Microbial contamination, Multidose vial

Citation Information : Renu SM, Rao AP, Biranthabail D, Mahabala KY, Panakaje AN. Screening for Microbial Contamination of Multi-dose Lignocaine Vials in a Dental Hospital: A Prospective Study. Int J Clin Pediatr Dent 2023; 16 (5):678-680.

DOI: 10.5005/jp-journals-10005-2614

License: CC BY-NC 4.0

Published Online: 10-11-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: Multidose vials (MDVs) for local anesthetic injections are routinely used in dental practice. MDVs contain multiple doses of a parenteral drug intended for administration to the same or multiple patients. Potentially harmful microbes have been shown to be able to live and occasionally multiply in MDVs if not handled aseptically. The goal of this study thus was to evaluate the bacterial and fungal contamination (FC) of lignocaine MDVs after use in a dental hospital. Materials and methods: A total of 27 MDVs of lignocaine free of any microbial contamination were distributed to different departments of the dental hospital and they were asked to use them on patients routinely. The samples were recollected from the departments either at the end of the 28th day or as and when the contents in the MDVs reached a predetermined level marked on the bottle during its usage, whichever was earlier. These leftover samples were subjected to a microbiological investigation by inoculation into thioglycolate broth and subsequent subculturing onto agar plates. Results: None of the inoculated broths showed turbidity. Subcultured agar plates, even on the 7th day of incubation, did not show any bacterial or fungal growth. The lignocaine MDVs tested after use were thus found to be sterile. Conclusion: There was no bacterial or FC detected in MDVs of lignocaine subjected to testing after use in the dental hospital. Clinical significance: Multidose vials (MDVs) continue to be used in clinics for economic reasons. But the clinician opting for MDVs should be conscious of their potential for microbial contamination and should meticulously follow the protocol for their aseptic use.


HTML PDF Share
  1. Baniasadi S, Dorudinia A, Mobarhan M, et al. Microbial contamination of single- and multiple-dose vials after opening in a pulmonary teaching hospital. Braz J Infect Dis 2013;17(1):69–73. DOI: 10.1016/j.bjid.2012.09.005
  2. Longfield RN, Smith LP, Longfield JN, et al. Multiple-dose vials: persistence of bacterial contaminants and infection control implications. Infect Control 1985;6(5):194–199. DOI: 10.1017/s0195941700061415
  3. Mattner F, Gastmeier P. Bacterial contamination of multiple-dose vials: a prevalence study. Am J Infect Control 2004;32(1):12–16. DOI: 10.1016/j.ajic.2003.06.004
  4. Melnyk PS, Shevchuk YM, Conly JM, et al. Contamination study of multiple-dose vials. Ann Pharmacother 1993;27(3):274–278. DOI: 10.1177/106002809302700302
  5. Thompson DF, Letassy NA, Gee M, Kolar GR. Contamination risks of multidose medication vials: a review. J Pharma Tech 1989;5(6): 249–253.
  6. Thompson GD, Thompson DF. The effect of the number of withdrawals on the sterility of multidose medication vials. J Clin Pharm Ther 1992;17(1):61–64. DOI: 10.1177/8755122589005006
  7. Santell JP. Expiration dating of multidose vials. Am J Hosp Pharm 1992;49(11):2672–2673.
  8. US Pharmacopeial Convention (USP). Antimicrobial effectiveness testing. United States Pharmacopeia, 25th revision. Rockville, MD: USP, 2001:1869–1871.
  9. Kirschke DL, Jones TF, Stratton CW, et al. Outbreak of joint and soft-tissue infections associated with injections from a multiple-dose medication vial. Clin Infect Dis 2003;36(11):1369–1373. DOI: 10.1086/375064
  10. Grohskopf LA, Jarvis WR. Outbreaks associated with medical devices and medications. Semin Infect Control 2001;1:111–122.
  11. Motamedifar M, Askarian M. The prevalence of multidose vial contamination by aerobic bacteria in a major teaching hospital, Shiraz, Iran, 2006. Am J Infect Control 2009;37(9):773–777. DOI: 10.1016/j.ajic.2008.12.009
  12. https://www.cdc.gov/injectionsafety/PDF/Injection-Safety-For-Healthcare-P.pdf [Accessed on 08/08/2022].
  13. United States Pharmacopeia (USP) 797: Guidebook to Pharmaceutical Compounding – Sterile Preparations. Second Edition, 1st June 2008.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.