A2: Microbes in the News

Article Title: Microbiological Contamination of Drugs during Their Administration for Anesthesia in the Operating Room

Date: April 2016

Author: Derryn A. Gargiulo, M.Pharm.Clin., Reg.Pharm.N.Z.; Simon J. Mitchell, Ph.D., F.A.N.Z.C.A.; Janie Sheridan, Ph.D., Reg.Pharm.N.Z., F.R.Pharm.S.; Timothy G. Short, M.B.Ch.B., M.D., F.A.N.Z.C.A.; Simon Swift, Ph.D.; Jane Torrie, M.B.Ch.B., F.A.N.Z.C.A.; Craig S. Webster, Ph.D.; Alan F. Merry, M.B.Ch.B., F.F.P.M.A.N.Z.C.A., F.R.C.A., F.A.N.Z.C.A.

Source: American Society of Anesthesiologists

Link: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2491392&resultClick=3

Summary: This article talks about the frequent lapses in aseptic techniques used in the operating room today, particularly with tools administering drugs to patients. Especially in large, busy hospitals were preoperative environments can get quite hectic, the aseptic techniques can often be overlooked during the sense of urgency to keep the patient on track for their scheduled surgery. This is in contrast with a normal, slower paced clinic setting where the anesthesiologist has ample time to set up equipment and utilize aseptic techniques as well as enough time between patients. The study was done in a major teaching hospital in New Zealand. They were able to obtain pathogenic microbes from 6.3% out of 300 general anesthesia procedures.

Connection: They talk a lot about how they swabbed the syringes and what they did to obtain their samples as well as what they did with them afterwards. They used multiple types of agar plates, included horses blood plates to culture different bacteria. They utilized the quadrant streaks, Gram-stains, and incubation. These are all things that we have done in lab.

Critical Analysis: I found this article very interesting. When we think of post-operative infections we rarely think that the anesthesiologist would play a part in that because they just administer the drugs to keep us asleep. They don’t exactly put their hands inside the patient like the surgeon does.

Question: What steps could be taken in order to ensure that all surgical equipment is suitable for surgery? There is an entire position devoted to sterilizing surgical equipment, but something seems to always slip through the cracks. Most syringes and needles are put into sterile packaging, I wonder if there is something that could be put in the paper of those packages that could potentially kill anything that was not cleared off during sterilization

2 Comments for “A2: Microbes in the News”

kv

says:

Hello,
I agree with you on this article to be very interesting because the cause of this growth was not determined with 100%. In a busy hospital, there are a lot of patients and the flow is fast. The anesthesiologist “do not exactly put their hands on” but they still “prepare” the hands for the procedure. To answer you question, I would suggest to implement single-use equipment for administering boluses. More single-use items, the less chances to have the equipment to be exposed to air. Remember, the very 1st sampling for our term project when we were not supposed to have the TSA plate exposed to air for a long time because microbes are “everywhere”. That’s why, for this research it could be possible to acquire microbes from the air. Plus, the weather in New Zealand is warm and I hope that samples transportation to the lab was short and “cold”, and not contaminated during the inoculation. Plus, the sterility of all solutions in the Lab is questionable. Overall, the percentage of found bacteria is low. Also, I didn’t find information if the air in the surgery room was filtered or not (i.e., air flow due to high activity in the hospital).

alfrary

says:

I agree with the above commenter about the possible solution of using single-use instruments. That was my initial thought as well, though I understand economically that would be expensive. Another solution might be having additional personnel whose sole purpose is the cleaning/maintenance of the instruments as well as a quality control overseer, who can regularly test the instruments to insure continued proper cleaning/sterilizing. This too would also be an added expensive. Unfortunately, even the best methods and procedures can fall victim to human error.

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