Abstract • Propofol is an intravenous anesthetic agent that was approved by the US Food and Drug Administration in October 1989. It has gained rapid acceptance and is in widespread use. In June 1990, the Centers for Disease Control reported four clusters of postsurgical infections associated with the use of propofol. We describe one of those clusters, consisting of four cases of endogenous Candida albicans endophthalmitis. These infections occurred in nonimmunocompromised patients after they had undergone nonophthalmologic surgery in which propofol had been used as anesthesia. An investigation by the Centers for Disease Control concluded that the infections in these patients were due to extrinsic contamination of propofol during preparation for use at the hospital. Ophthalmologists should be aware of this new potential source of endogenous endophthalmitis. References 1. Postsurgical infections associated with an extrinsically contaminated intravenous anesthetic agent—California, Illinois, Maine, and Michigan, 1990 . MMWR . 1990;39:426-433. 2. Langley MS, Heel RC. Propofol: a review of its pharmacodynamic and pharmacokinetic properties and use as an intravenous anesthetic . Drugs . 1988;35:334-372.Crossref 3. Larijani GE, Gratz I, Afshar M, Jacobi AG. Clinical pharmacology of propofol: an intravenous anesthetic agent . DICP . 1989;23:743-749. 4. Kashtan H, Edelist G, Mallon J, Kapala D. Comparative evaluation of propofol and thiopentone for total intravenous anaesthesia . Can J Anaesth . 1990;37:170-176.Crossref 5. Sebel PS, Lowdon JD. Propofol: a new intravenous anesthetic . Anesthesiology . 1989;71:260-277.Crossref 6. Mallon JS, Edelist G. Total intravenous anaesthesia . Can J Anaesth . 1990;37:279-281.Crossref 7. Boysen K, Sanchez R, Krintel JJ, Hansen M, Haar PM, Dyrberg V. Induction and recovery characteristics of propofol, thiopental and etomidate . Acta Anaesthesiol Scand . 1989;33:689-692.Crossref 8. White PF. Clinical pharmacology of intravenous induction drugs . Int Anesthesiol Clin . 1988;26:98-104.Crossref 9. Heath PJ, Kennedy DJ, Ogg TW, Dunling C, Gilks WR. Which intravenous induction agent for day surgery? a comparison of propofol, thiopentone, methohexitone, and etomidate . Anaesthesia . 1988;43:365-368.Crossref 10. Dundee JW, Clarke RS. Propofol . Eur J Anaesthesiol . 1989;6:5-22. 11. Rothman R, Kay M, Packo K. Growth of Candida albicans in commercially prepared propofol: clinical implications . Invest Ophthalmol Vis Sci . 1991;32( (suppl) ):199. 12. Kempen PM. Avoiding nosocomial infection in anaesthesia . Can J Anaesth . 1989;36:254-255.Crossref 13. Lessard MR, Trepanier CA, Gourdeau M, Denault PH. A microbiological study of the contamination of the syringes used in anaesthesia practice . Can J Anaesth . 1988;35:567-569.Crossref 14. Kempen PM, Learned DW. Anaesthesia practice: a vector of infection? Anesthesiology . 1989;71:A948.Crossref 15. Rosenberg AD, Bernstein RL, Ramanathan S, Albert DB, Marshall MH. Do anesthesiologists practice proper infection control precautions? Anesthesiology . 1989;71:949. Abstract.Crossref 16. Antley PP, Hazen KC. Role of yeast growth temperature on Candida albicans virulence in mice . Infect Immun . 1988;56:2884-2890. 17. Patterson JS, Hopkins KJ, Albanese R. Preparation and use of propofol . Anaesthesia . 1990;45:1002.Crossref
Archives of Ophthalmology – American Medical Association
Published: Aug 1, 1991
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