Sterility of total parenteral nutrient solutions stored at room temperature for seven days. 1989

J Takagi, and N Khalidi, and R A Wolk, and E Tjolsen, and R de Leon, and J R Wesley
Kenneth Norris Jr. Cancer Hospital, Los Angeles, CA.

The sterility of total parenteral nutrient (TPN) solutions stored at room temperature for up to seven days after preparation was studied. The study was conducted in two parts. In part 1, a positive control phase was conducted to validate that the filter set would capture bacteria or fungi in the TPN solutions. In part 2,300 unused TPN solutions were retrieved from patient-care areas within 24 hours of preparation. These solutions were randomized into three study groups of 24, 72, or 168 hours after preparation. Each TPN solution was filtered aseptically using an inline 0.22-micron filter. The filters were suspended in brain-heart infusion broth and incubated at 35 degrees C. Filters were visually evaluated for turbidity as an indicator of microbial contamination. Microbial growth was reported in 2 of 100 samples filtered 24 hours after preparation (group 1) and in 1 of 100 samples filtered 72 hours after preparation (group 2). No growth was detected in TPN solutions filtered 168 hours after preparation (group 3). Turbid samples were subcultured, and contaminants were identified as coagulase-negative Staphylococcus species and gram-positive bacilli in the group 1 samples and coagulase-negative Staphylococcus species in the group 2 samples. The difference in contamination rates among the three groups was not significant. TPN solutions may be stored after preparation at room temperature for an extended time (up to 168 hours) without increasing the risk to patient safety. However, at this institution, expiration dates are extended only to the time that supports practical recycling of standard TPN solutions (72 hours).

UI MeSH Term Description Entries
D009391 Nephelometry and Turbidimetry Chemical analysis based on the phenomenon whereby light, passing through a medium with dispersed particles of a different refractive index from that of the medium, is attenuated in intensity by scattering. In turbidimetry, the intensity of light transmitted through the medium, the unscattered light, is measured. In nephelometry, the intensity of the scattered light is measured, usually, but not necessarily, at right angles to the incident light beam. Turbidimetry,Nephelometry,Turbidimetry and Nephelometry
D010289 Parenteral Nutrition, Total The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins. Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D004356 Drug Storage The process of keeping pharmaceutical products in an appropriate location. Drug Storages,Storage, Drug,Storages, Drug
D005516 Food Microbiology The presence of bacteria, viruses, and fungi in food and food products. This term is not restricted to pathogenic organisms: the presence of various non-pathogenic bacteria and fungi in cheeses and wines, for example, is included in this concept. Microbiology, Food
D013242 Sterilization The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means.

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