Are multiple-use bottles of chlorhexidine solutions at risk of contamination in joint replacement surgery?

Introduction: Chlorhexidine gluconate 2% w/v in isopropanol 70% solutions in multiple-use bottles is commonly used in surgery as a cost-effective method for skin disinfection. However, multiple-use bottles risk contamination. This study aims to test whether bacterial contamination of multiple-use bottles or their solutions occurs once open and on use between different patients.

Methods: Consecutive samples were taken each time a chlorhexidine bottle was used over a 7-day study period. Samples were tested using blood culture, agar plate and mass spectrometry.

Results: No growth was observed in 52 samples taken from 18 bottles inoculated into blood culture bottles. Four growths on agar plate culture were determined to be contaminants from the sampling process.

Conclusions: This study supports the use of multiple-use bottled chlorhexidine solutions as safe and cost-effective in surgical practice.