Risk of Fungal Contamination of Ointments and Tablets after Opening of the Package for Use in Hospitals

Background and purpose: Tablets and ointments are used to prevent, treat, and diagnose diseases in hospitals. Although it seems that these medications are sterile in the path of the building and packaging, their mishandling or wrong application method can cause them to be contaminated. Hence, the preservation of pharmaceutical forms from contamination before and after opening the cover in hospitals is an essential measure to be taken in health care. The objective of the present study was to investigate the challenges in fungal contaminants detection and recovery in some pharmaceuticals that were high intake for patients.   Materials and methods:  This study was conducted in 4 teaching hospitals on 4 types of tablets and 3 types of ointments that were high intake for patients in hospitals before and after opening and usage in Sari, Iran. Fungi were identified by using standard mycology procedures. Results: The results showed that among the samples of tablets after opening the cover in the delivery room and carrying them in container by trolley, and the samples of ointments after opening and usage, the contamination rates were 70.3% and 94.4-100%, respectively. Aspergillus species such as A. flavus and A. fumigatus were the most mold species and Rhodotorula spp. was the most yeast species isolated. However, it was documented that 16.7% of some pharmaceuticals had fungal contamination ahead of opening. Conclusion: The results showed the contamination of ointments and tablets used in hospitals after opening the cover. Although the source of contamination was not investigated in the present study, the findings revealed that most of the contaminations could be due to the storage period and mishandling in pharmacies and wrong application methods after opening. Some isolated fungi can also be harmful to patients who have a weakened immune system.