Evaluation Of The Efficacy Of Transfusion Fluids Prepared At The Sterile Preparation Unit In Kenyatta National Hospital.

Abstract

Transfusion fluids are parenteral solutions injected in relatively large volumes to restore the caloric or electrolytic balance of the body. They are introduced directly into the venous system or very rarely by hypodermoclysis. This, therefore, necessitates that they be sterile. Sterilisation means an act or process of destroying completely all forms of microbial life including viruses. An article is either sterile or non-sterile and there is no such condition as partial sterility. It is, therefore, necessary to demonstrate that no viable organisms are present in the intravenous infusions. Houjever, despite standards of quality control and general standards of good manufacturing practices, large scale epidemics caused by intrinsic contamination (that is, microbial contamination originating at the level of the manufacturer) of parenteral fluids have occurred. (Anon: Septicemias associated with contaminated intravenous fluids - Winconsin, Ohio, M0rb Mortal Weekly Rep 22:99 March 1973) The United States Pharmacopoeia Sterility tests are based on the concept that a negative result indicates absence of all micro-organisms and the testing methods are geared towards numbers of microbes rather than their identities. However, relationships between hosts and microbes vary. Many microbes thought to be commensal can cause infection, given the right circumstances, for example, normal intestinal flora. Therefore, until all conditions with regard to disease are known every organism is suspect (Dubois, RZ) and Hirsch, 3.9: Bacterial and Mycotic Infections of Man 4th Edition). For these reasons it was the aim of this project to investigate both numbers and types of micro-organisms that my be found in intravenous transfusion fluids manufactured at the Sterile Preparation Unit at Kenyatta National Hospital and thereby test the sterility of the products before administration.