Abstract:
Background: Injectable liquid medications are provided in either single or multiple dose vials for
parenteral administration under the appropriate aseptic conditions. These vials are prone to
bacterial contamination after opening and could be potential reservoirs of microorganisms that
could be transmitted to the patient through the parenteral route. There have been reports of
outbreaks of infectious diseases, especially in low and middle-income countries emanating from
improper handling and use of parental medications. The present study aims at assessing the
magnitude of the problem and associated factors at Jimma Medical Center, Jimma Southwest
Ethiopia.
Methods: An institutional based cross-sectional study design was conducted at Jimma Medical
Center from July 2021 to October 2021. One hundred microliters of parental medications were
withdrawn with a sterile needle and syringe from a total of 384 parental medications (61.5%
multiple and 38.5% single-dose vials) that were administered in 11 wards and 3 intensive care
units. Besides, self-administered structured questionnaire was used to collect data about risk
factors for vial contamination from nurses. Samples were processed onto appropriate culture
media and bacteria were isolated and identified using gram staining and a series of biochemical
tests. An antimicrobial susceptibility test was performed based on Kirby Bauer Disk diffusion
technique. Data were entered by Epi data and analyzed by SPSS version 23 the P-value of less
than 0.05 was considered as statistically significant.
Result: The overall prevalence of vial contamination due to aerobic bacteria was 21(5.5%)
among multiple-dose and none of the single-dose vials. The highest contamination 8(38.1%) was
found in the pediatric ward. P. aeruginosa 6(28.5 %) and K. pneumoniae 5(23.8%) were the
most common agents of vial contamination. Multidrug resistance rate of isolates was found
among 95.2% of the isolates with all gram-negative isolates showed multidrug resistance rate
against tested antibiotics. In multivariate logistic regression analysis, vial contamination was
strongly associated with reuse of syringe and/or needle, medication drawing environment, and
storage conditions.
Conclusions: In this study, the prevalence of vial contamination was high. The bacterial isolates
from vials were also highly resistant to commonly prescribed antimicrobial drugs. Healthcare
professionals must strictly adhere to basic infection control practices as per standard guidelines.
