BACTERIAL-COLONIZATION AND ENDOTOXIN CONTAMINATION OF INTRAVENOUS-INFUSION FLUIDS

Bacterial colonization and endotoxin contamination of intravenous infu sion fluids and catheter systems were examined in a surgical intensive care unit. Nineteen consecutive patients were randomly assigned to 48 h (N=8) or 96 h (N=11) change of infusion systems. Fluid from infusio n bottles (51), infusion bottles plus burettes (102) and catheter syst ems (104) was cultured quantitatively for aerobic and anaerobic bacter ia. Swabs (362) were taken from three-way stopcocks before and after t he in-line infusion filters. Total and free endotoxin levels in infusi on fluids were measured by quantitative chromogenic Limulus assay. The overall rate of bacterial colonization of bottles/burettes was 7.8% a t 48 h and 15.7% at 96 h, while colonization rates of catheter fluid w ere 34.0% and 24.1%, respectively (n.s.). These high rates of coloniza tion, despite regularly reinforced hand disinfection practices, may be explained by the high frequency of manipulations of the catheter syst ems, during acute interventions in emergency situations. Cell-bound en dotoxin was found in 8.8% of the samples, but only 2.5% of the samples contained free endotoxin. The data support the use of in-line infusio n filters, with bacterial-retaining property; however, these filters n eed not have endotoxin-retaining properties.