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Volume 22, Number 6—June 2016

Infectious Disease Risk Associated with Contaminated Propofol Anesthesia, 1989–20141

Andrés Zorrilla-VacaComments to Author , Jimmy J. Arevalo, Kevin Escandón-Vargas, Daniel Soltanifar, and Marek A. Mirski
Author affiliations: Universidad del Valle School of Medicine, Cali, Colombia (A. Zorrilla-Vaca, K. Escandón-Vargas); Fundación Universitaria de Ciencias de la Salud, Bogota, Colombia (J.J. Arevalo); Royal Free Hospital, London, United Kingdom (D. Soltanifar); Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (M.A. Mirski)

Main Article

Table 2

Microorganisms identified in propofol anesthesia-related iatragenic infection outbreaks, single cases, or laboratory-based studies of syringes, vials, or infusion lines*

Category and microorganism Type of infection % Infections† References
Gram-positive bacteria 27.08
Staphylococcus aureus BSI, SSI 27.08 (2,6,8,30)
S. epidermidis (23,27,30,31)
MRSE§ SSI (31)
Streptococcus salivarius (22)
Enterococcus faecalis‡ (32)
Micrococcus sp.‡ (23,25,27)
Corynebacterium sp.‡ (23)
Bacillus sp.‡ (23,25)
Diphtheroids sp.‡ (25)
Kocuria sp.‡

Gram-negative bacteria 20.14
Serratia marcescens BSI, SSI 9.72 (2,4,15,30)
Enterobacter cloacae BSI 2.78 (31)
E. agglomerans BSI 2.78 (2)
Pseudomonas cepacia§ BSI (34)
P. aeruginosa§‡ SSI # (30,33)
Escherichia coli§ BSI (35)
Klebsiella pneumoniae BSI 3.47 (10,15)
Moraxella osloensis BSI, SSI 1.39 (6)
Acinetobacter sp.‡

Fungus 21.53
Candida albicans
Viruses 22.53
HCV Hepatitis C 18.06# (9,1113)
HBV Hepatitis B 4.17 (12)

*Outbreak, >2 cases; BSI, bloodstream infection; SSI, surgical site infection; MRSE, methicillin-resistant Staphylococcus epidermidis; HCV, hepatitis C virus; HBV, hepatitis B virus; dashes indicate no infections identified
†Percentage of infection estimated among the total of victims involved only in outbreaks in which a pathogen was identified (n = 131). In total, 9.03% of the patients reported in the outbreaks had no microorganisms identified, in part because the cultures were obtained after administration of antimicrobial drugs.
‡Microorganisms that have been identified by culture of residual propofol after clinical use but so far have not been involved in propofol-related outbreaks or infection associated with propofol.
§MRSE, P. cepacia, P. aeruginosa, and E. coli have been identified in case reports of infection and septic shock, but so far have not been involved in propofol-related outbreaks.
#P. aeruginosa and HCV have been implicated in outbreaks in Catalonia and Galicia, Spain. However, these reports appeared in newspapers and because of that were not included in this synopsis article ( and

Main Article

1Part of this work was presented at the XXXI Colombian Congress of Anesthesiology and Critical Care, Cali, Columbia, July 2015.

Page created: May 11, 2016
Page updated: May 11, 2016
Page reviewed: May 11, 2016
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