Ophthalmic solutions used in a long-term care facility found to be contaminated

Eight percent of ophthalmic solutions used for treating patients at a long-term care facility were contaminated with bacteria, according to a study by researchers in New York. In particular, steroid-containing solutions were almost six times more likelyto be contaminated compared with nonsteroid solutions, the study authors noted.

Danny H-Kauffmann Jokl, MD, and colleagues cultured 123 multiple-dose ophthalmic solutions for bacteria. The culture results were analyzed according to each solution's therapeutic class, how long the bottle had been in use and how the bottle appeared on visual inspection, according to the study.

The researchers found that 10 solutions (8%) were contaminated, primarily by the organism Proteus mirabilis, which was identified in eight solutions (80%).

Specifically, four of eight (50%) steroid-containing anti-inflammatory solutions, two of six (33%) combination antimicrobial and steroid-containing anti-inflammatory solutions, two of 34 (6%) glaucoma drug solutions and two of 57 (4%) dry eye medications were contaminated.

No mydriatic, miotic or non-combination antimicrobial solutions were found to be contaminated, the authors noted.

"Compared with solutions not containing steroids, steroid solutions were 5.8 times more likely to be contaminated," they said.

Additionally, only 30% of the contaminated solution bottles were classified as "dirty" upon visual inspection. Also, neither the length of time the solutions had been in use nor the appearance of the bottle upon visual inspection predicted contamination.

"The frequent contamination during reuse of certain steroid-containing ophthalmic solutions raises the question of whether single-use solutions might be preferred for these and other classes of ocular drugs," the authors said.

The study is published in the October issue of British Journal of Ophthalmology.