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The EmulSiv^TM filter removes microbial contamination from propofol but is not a substitute for aseptic technique

[Le filtre EmulSiv^TM élimine la contamination microbienne du propofol, mais ne remplace pas l’asepsie]

Wendy C. E. Hall, MD^*, Donald T. Jolly, MD FRCP^*, Jiri Hrazdil, MD FRCP, John C. Galbraith, MD FRCP, Maria Greacen, MLT and Alexander S. Clanachan, PhD

^* From the Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, Walter C. Mackenzie Health Sciences Centre;
the Department of Anesthesia, Royal Alexandra Hospital;
the Dynacare Kasper Medical Laboratories;
the Faculty of Pharmacy and Pharmaceutical Science, University of Alberta, Edmonton, Alberta, Canada.

Address correspondence to: Drs. Donald T. Jolly and Wendy C.E. Hall, Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, 3B2.32 Walter C. Mackenzie Health Sciences Centre, 8440 - 112 Street, Edmonton, Alberta T6G 2C7, Canada. Phone: 780-486-7469; Fax: 780-407-3200; E-mail: dtjolly{at}compusmart.ab.ca

Purpose: To evaluate the ability of the EmulSiv^TM filter (EF) to remove extrinsic microbial contaminants from propofol.

Methods: Aliquots of Staphylococcus aureus (S. aureus), Candida albicans (C. albicans), Klebsiella pneumoniae (K. pneumoniae), Moraxella osloensis (M. osloensis), Enterobacter agglomerans (E. agglomerans), Escherichia coli (E. coli), Serratia marcescens (S. marcescens), Moraxella catarrhalis (M. catarrhalis), Haemophilus influenzae (H. influenzae) and Campylobacter jejuni (C. jejuni) were inoculated into vials containing 20 mL of sterile propofol. The unfiltered inoculated propofol solutions served as controls. Ten millilitres and 20 mL samples of the inoculated propofol were filtered through the EF. All solutions were then subplated onto three culture plates using a precision 1 µL calibrated platinum loop and incubated. The number of colony forming units (CFU) were counted. Data were analyzed using a one-sample t test, and a P value of less than 0.05 was selected as the level of statistical significance.

Results: The EF was able to completely remove CFU of S. aureus, C. albicans, K. pneumoniae, M. osloensis, E. agglomerans, E. coli, S. marcescens, and M. catarrhalis (P < 0.05). A small number of H. influenzae CFU were able to evade filtration in both the 10 mL and 20 mL samples. C. jejuni CFU were able to evade filtration in only the 10 mL sample.

Conclusions: The EF removes the majority of microbial contaminates from propofol with the exception of H. influenzae and C. jejuni. Although the EF is capable of removing most of the microbial contamination produced by H. influenzae and C. jejuni, a few CFU are capable of evading filtration. Consequently, even the use of a filter capable of removing microbial contaminants is not a substitute for meticulous aseptic technique and prompt administration when propofol is used.

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				C. A. Trepanier and M. R. Lessard Propofol and the risk of transmission of infection/Le propofol et le risque de transmission d'infection Can J Anesth, June 1, 2003; 50(6): 533 - 537. [Full Text] [PDF]