Dr Sidana has raised an important issue. The air does carry bacteria,
spores, etc. The particulate matter in air is also likely to be
contaminated. The degree of contamination of air is variable depending on
the quality of air handling system in use. It is well documented that use
of non-vented systems for delivering iv fluids leads to a decrease in the
bacteremias(1,2). The use of rigid/ semi-rigid bottles, which require an
air-vent are more likely to be contaminated due to the vented air. The
bacteria have been shown to proliferate in the intravenous fluid(3). The
available data suggests that the air, that enters the IV fluid bottles
through a vent (in-built in the IV set or a needle that is inserted into
the bottle), is likely to increase the risk of bacteremia in children.
On the other hand, the volume of air that would come in
contact with the medications in a vial/ ampule is likely to be small. So,
the risk of contamination and that of infection due to contact of
medication with air in recipients of IM/IV medi-cations is likely to be
small. However, it may be desirable to prepare all injections under a
sterile hood/laminar flow, particularly when these have to used in at-risk
patients such as preterm neonates, immunocompromised children, critically
ill children in PICU.
References
1. Useh MF, Mbouda B. Risk of contamination from air
vents during intravenous fluid administration. East Afr Med J 1998; 75:
322-326.
2. Rosenthal VD, Maki DG. Prospective study of the
impact of open and closed infusion systems on rates of central venous
catheter-associated bacteremia. Am J Infect Control 2004; 32:135-141.
3. Lamikanra A, Sofekun MO. Ability of bacteria
isolated from the hospital environment to proliferate in infusion fluids.
Microbios 1988; 55: 115-125.