Bacterial Contamination of Single- And Multiple-Dose Parenteral Injection Vials after Opening and Antibiotic Susceptibility of Isolates at Jimma Medical Center, Jimma, Southwest Ethiopia

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 One hundred microliters of parental medications were withdrawn with a sterile needle and syringe from a total of 384 parental medications (61.5% multiple and 38.5% single-dose vials) that were administered in 11 wards and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.