Contamination rate in open-system filling adapters in operating room anesthesia work area in India: An in-vitro study

Objective: To evaluate the rate and type of contamination in open-system adapters used for filling the anesthetic agent sevoflurane across hospitals in India. Methods: Nineteen reusable adapters used for filling sevoflurane were collected from nine hospitals in India and evaluated for microbial contamination. Samples were collected by flushing the inner lumen and swabbing the outer surfaces of adapters and dispatched to a central laboratory in sealed sterile tubes/containers for culture and microbial identification. Results: Out of 19 swab samples collected from the outer surfaces, 11 (57.9%) were found to be contaminated/colonized. Out of these, 5 (26.3%) were found to be contaminated with Gram-positive cocci belonging to the Staphylococcus species, and 6 (31.6%), with Gram-negative organisms Pseudomonas aeruginosa (5 [26.3%]) , and Burkholderia cepacian (1 [5%]). Out of 19 rinse samples from the inner lumens, 8 (42.1%) were found to be contaminated, 2 (10.5%) with Gram-positive cocci belonging to Staphylococcus species and 6 (31.6%) with Gram-negative organisms Achromobacter denitrificans and Aeromonas enteropelogene (one (5.3%) sample each), and Pseudomonas aeruginosa and Ralstonia pickettii (2 (10.5%) samples each). Conclusion: Reusable open-system filling adapters are susceptible to contamination with nosocomial pathogens; therefore, single-use adapters to inhibit contamination and prevent hospital ‐ acquired infections should be encouraged.