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An epidemic in a coronary care unit caused by Pseudomonas species
Abstract:
Five patients in a coronary care unit were involved in an epidemic caused by a nonfermenting Gram-negative bacillus, presumptively identified by our laboratory as Pseudomonas cepacia. All medications administered intravenously to these patients were cultured. Because morphine was the only such medication common to the treatment of all the patients involved, a vial used in the unit at that time was cultured, as were two previously-entered vials of saline solution and several sterile vials of distilled water used in the preparation of injectable medication. The Pseudomonas cepacia organism was recovered from one of the vials of saline solution. The epidemic ended as soon as the practice of re-entering the vials of sterile saline solution was discontinued.
Insights
A Pseudomonas cepacia outbreak in a coronary care unit was traced to contaminated saline solution vials. Discontinuing the reuse of these vials immediately halted the epidemic.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Coronary care units are vulnerable to hospital-acquired infections.
- Pseudomonas cepacia can cause serious infections in immunocompromised patients.
Observation:
- An epidemic involving five patients occurred in a coronary care unit.
- A nonfermenting Gram-negative bacillus, identified as Pseudomonas cepacia, was the causative agent.
Findings:
- Intravenous medications administered to affected patients were cultured.
- Pseudomonas cepacia was isolated from a vial of saline solution, a common medication vehicle.
- The epidemic ceased upon discontinuation of reusing saline vials.
Implications:
- This highlights the critical importance of sterile technique in healthcare settings.
- Contaminated intravenous solutions pose a significant risk for patient infection.
- Strict adherence to protocols for medication preparation and administration is essential to prevent outbreaks.