{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:07:08Z","timestamp":1740146828267,"version":"3.37.3"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011490","name":"College of Veterinary Medicine, North Carolina State University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011490","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Objective<\/jats:title><jats:p>To determine whether bupivacaine liposomal injectable suspension (BLIS) supports microbial growth when artificially inoculated and to evaluate liposomal stability in the face of this extrinsic contamination as evidenced by changes in free bupivacaine concentrations.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Study design<\/jats:title><jats:p>A randomized, prospective<jats:italic>in vitro<\/jats:italic>study in which three vials of each BLIS, bupivacaine 0.5%, and propofol were individually inoculated with known concentrations of<jats:italic>Escherichia coli<\/jats:italic>,<jats:italic>Pseudomonas aeruginosa<\/jats:italic>,<jats:italic>Staphylococcus aureus<\/jats:italic>, and<jats:italic>Candida albicans<\/jats:italic>(n = 36) to quantify bacterial and fungal growth was conducted. Over 120 hours, aliquots from contaminated vials were withdrawn, plated, and incubated to determine microbial concentrations. High-pressure liquid chromatography (HPLC) was used to evaluate free bupivacaine concentrations over time in BLIS. Data were analyzed using a mixed effects model with multiple comparisons.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Sample population<\/jats:title><jats:p>Twelve vials of each BLIS, bupivacaine 0.5%, and propofol.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Results<\/jats:title><jats:p>BLIS did not support significant growth of<jats:italic>Staphylococcus aureus<\/jats:italic>or<jats:italic>Candida albicans<\/jats:italic>at any time. BLIS supported significant growth of<jats:italic>Escherichia coli<\/jats:italic>and<jats:italic>Pseudomonas aeruginosa<\/jats:italic>beginning at the 24 hour time point. Bupivacaine 0.5% did not support significant growth of any organisms. Propofol supported significant growth of all organisms. Free bupivacaine concentrations changed minimally over time.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Conclusion<\/jats:title><jats:p>Bacterial and fungal contaminant growth in artificially inoculated BLIS is organism dependent. BLIS supports significant growth of<jats:italic>Escherichia coli<\/jats:italic>and<jats:italic>Pseudomonas aeruginosa<\/jats:italic>. Extra-label handling of BLIS should only be undertaken with caution and with adherence to strict aseptic technique.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0281768","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T18:26:07Z","timestamp":1676571967000},"page":"e0281768","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative growth dynamics of bacterial and fungal contaminants in bupivacaine liposomal injectable suspension, bupivacaine 0.5%, and propofol"],"prefix":"10.1371","volume":"18","author":[{"given":"Amber","family":"Wallace","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Love","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Gensler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Jacob","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6115-042X","authenticated-orcid":true,"given":"James","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8161-4482","authenticated-orcid":true,"given":"Kristen","family":"Messenger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"issue":"4","key":"pone.0281768.ref001","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/S0195-5616(08)70009-3","article-title":"Pharmacologic Considerations for Opiate Analgesic and Nonsteroidal Anti-Inflammatory Drugs","volume":"30","author":"M. 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