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Journal of Parenteral and Enteral Nutrition
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Original Communications

Microbiologic Quality-Control Study for the Purpose of Extending the Use of Transfer Sets on the Automix 3+3 and Micromix Automated Total Nutrient Admixture Compounding Pumps

Kenneth Chung, BSc (Pharm) and Greg Head, BSc (Pharm)

From the Department of Pharmacy, St. Paul's Hospital, Vancouver, British Columbia, Canada

Correspondence: Kenneth Chung, BSc (Pharm), Clinical Pharmacist, Department of Pharmacy, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada. Electronic mail may be sent to kkchung{at}providencehealth.bc.ca.

Background: A quality-control study was undertaken by the departments of pharmacy and microbiology at St. Paul's Hospital (Vancouver, British Columbia, Canada) to evaluate the microbiologic safety of total nutrition admixtures (TNA) compounded by automated compounding pumps when the use of disposable transfer sets was extended from 1 day to 2 days. This study also evaluates the potential annual cost savings of this extended use. Methods: Transfer sets and unused part containers of ingredients were left to sit overnight on the automated compounders after daily TNA manufacturing before a TNA sample was compounded for culturing. These TNA samples were cultured using a biphasic system consisting of a tryptic soy broth component and an agar slide component. Positive results were subcultured and isolates were identified by standard methods. Forty samples were collected and evaluated. Results: Four bags grew Bacillus species, and 1 bag grew coagulase-negative staphylococci. The potential annual cost savings of this extended use was estimated to be ~$35,000. Conclusions: The extended use of the disposable transfer sets cannot be instituted at the present time and should be reexamined when the cause(s) of the positive results are identified and corrected.

Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 2, 118-124 (2005)
DOI: 10.1177/0148607105029002118
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