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EMULSIV^TM FILTER FOR REMOVAL OF MICROORGANISMS FROM PROPOFOL

^* Department of Anesthesiology and Pain Medicine,
^# University of Alberta Hospitals, 8440 112 Street, Edmonton, Alberta, Canada, T6G 2B7
Dynacare Kasper Medical Laboratories, 14940 123 Avenue, Edmonton, Alberta, Canada, T5V 1B4.

INTRODUCTION

Extrinsic contamination of propofol has been implicated in perioperative infection and death of patients.^{1, 2} The Pall EmulSiv^TM filter is a 0.45 micron rated filter, specifically designed for propofol administration. This study sought to determine the effectiveness of the EmulSiv^TM filter.

METHODS

Microbes previously documented to be associated with the extrinsic contamination of propofol were studied. Included were Staphylococcus aureus, Escherichia coli, Moroxella osloensis, Klebsiella pneumoniae, Candida albicans, Enterobacter agglomerans and Serratia marcescens. Moraxella catarrhalis, Haemophilus influenzae, and Campylobacter jejuni were studied because of their unusual shape or small size. Approximately 1.8 X 10⁶ organisms were inoculated into 20 ml sterile vials of propofol. Three 1µl samples were removed from the contaminated propofol mixture and plated onto three growth plates. The remainder of the contaminated propofol solution was filtered and three 1µl samples were taken and plated. All plates were incubated for 24 hours except for C.albicans and C. jejuni (slow growing organisms), which were incubated for 48 and 72 hours respectively. The number of colony forming units (CFU's) on each plate were counted twice. Values for replicate determinations (N=3) of CFU's are reported as the mean. The significance of the differences between the filtered and unfiltered CFU values for each organism was determined by a one-sample t-test.

RESULTS

The EmulSiv^TM filter completely removed nine out of ten of the microorganisms inoculated into propofol. Only H. influenzae was not completely filtered.

TABLE

Organism Total organism challenge Post-filtered growth FilterEfficacy % P value E. coli 7.8 X 105 0 100 0.0054 S. aureus 1.9 X 106 0 100 0.0242 K. pneumoniae 5.0 X 105 0 100 0.0260 M. catarrhalis 1.4 X 106 0 100 0.0044 M. osloensis 4.0 X 105 0 100 0.0098 E. agglomerans 7.4 X 105 0 100 0.0198 H. influenzae 3.6 X 106 6 X 103 99.8 0.0141 S. marcescens 1.7 X 106 0 100 0.0022 C. albicans 1.0 X 105 0 100 0.0377 C. jejuni 3.0 X 105 0 100 0.0059

DISCUSSION

The Emulsiv^TM filter is effective at removing microorganisms from propofol. Small organisms such as H. influenzae may be able to evade filtration. Also, as filters do not remove endotoxins, which are produced by some organisms, strict aseptic technique in accordance with the manufacturer's recommendation is essential. The routine use of filters may reduce the incidence of propofol contamination related perioperative infections.

REFERENCES

1 N Engl J Med. 333:147-54.

2 N Engl J Med. 333:184-185

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hall, W. C.E. Articles by Clanachan, A. S. Search for Related Content PubMed Articles by Hall, W. C.E. Articles by Clanachan, A. S.