Major articleContamination of intravenous fluids: A continuing cause of hospital bacteremia
Section snippets
Setting
The study was conducted in the hospital of the National Institute of Medical Sciences and Nutrition “Salvador Zubirán” (INNSZ) in Mexico City, a 180-bed referral center. The INNSZ has a consolidated infection control program with strong support from diagnostic microbiology. Blood specimens for culture are drawn routinely from patients with fever or other signs of sepsis. To prevent nosocomial bacteremia, the INNSZ has a team of 30 nurses who provide IV therapy care 24 hours a day. Although the
Results
A total of 384 infusates were cultured from 384 patients with reported GNR in the blood. On average, infusate cultures were obtained 27.2 hours after the blood specimens were collected for culture. A total of 11 infusates grew bacteria in culture, but only 8 of these were considered positive; the other 3 specimens grew coagulase-negative staphylococci (CNS) in broth only. An additional specimen grew a few CNS (30 CFU/mL) that differed from the organism found in the patient' s blood. Therefore,
Discussion
Our findings indicate that infusate contamination should not be underestimated as a cause of nosocomial bacteremia. In hospitals where IV admixtures are still prepared in nursing areas, implementing a policy of routine infusate culturing in patients with GNR bacteremia can increase the safety of IV therapy. At INNSZ, both the present study and an earlier study9 have served as sentinels. Current policy is that the detection of a contaminated infusate leads to an exhaustive analysis to identify
References (28)
- et al.
Endemic infusate contamination and related bacteremias
Am J Infect Control
(2008) - et al.
Nationwide epidemic of septicemia caused by contaminated infusion products: growth of microbial pathogens in fluids for intravenous infusion
J Infect Dis
(1975) - et al.
Parenteral infusions as culture media from a viewpoint of nosocomial bacteremia
Rev Invest Clin
(2000) - et al.
Postoperative infections traced to contamination of an intravenous anesthetic, propofol
N Engl J Med
(1995) - et al.
Pediatric primary gram-negative nosocomial bacteremia: a possible relationship with infusate contamination
Infect Control Hosp Epidemiol
(1996) - et al.
Extrinsic contamination of intravenous infusates administered to hospitalized children in Mexico
Pediatr Infect Dis J
(2000) - et al.
Control of pediatric nosocomial bacteremia by a program based on culturing of parenteral solutions in use
Salud Pub Mex
(1999) - et al.
RNeonatal sepsis in Egypt associated with bacterial contamination of glucose-containing intravenous fluids
Pediatr Infect Dis J
(2005) Infections caused by intravascular devices used for infusion therapy: pathogenesis, prevention, and management
- et al.
Nosocomial bacteremia in neonates related to poor standards of care
Pediatr Infect Dis J
(2005)
Guidelines for the prevention of intravascul catheter–related infections
Clin Infect Dis
National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1992 through June 2004, issued October 2004
Am J Infect Control
Genetic analysis of Pseudomonas aeruginosa isolates from the sputa of Australian adult cystic fibrosis patients
J Clin Microbiol
Contamination of intravenous infusion fluid: effects of changing administration sets
Ann Intern Med
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Conflicts of interest: None to report.