Nosocomial pediatric bacteremia: the role of intravenous set contamination in developing countries

Area of Science:

• Infectious Diseases
• Hospital-Acquired Infections
• Microbiology

Background:

• Intravenous (IV) administration sets are critical for delivering fluids and medications to hospitalized patients.
• Bacterial contamination of IV equipment poses a significant risk for healthcare-associated infections.
• Assessing contamination rates at injection ports and infusates is crucial for patient safety.

Purpose of the Study:

• To determine the prevalence of bacterial contamination on rubber injection ports of IV administration sets.
• To evaluate the rate of bacterial contamination in IV infusates.
• To investigate the link between injection port contamination and infusate contamination.

Main Methods:

• Cultures were performed on injection ports and infusates from IV sets during 26 hospital visits.
• The study was conducted in four public pediatric hospitals in Mexico City.
• Hospitalized pediatric patients receiving IV solutions were included.

Main Results:

• A high rate of contamination was observed, with 70.1% of injection ports positive for bacteria.
• Gram-negative rods, mainly Klebsielleae, were the predominant contaminants.
• Infusates showed lower contamination rates (6.8%), but shared bacterial species with injection ports in 1.2% of cases.
• A cluster of eight cases of injection port contamination with Enterobacter cloacae was identified, with the same organism found in a patient's blood culture and IV fluids.

Conclusions:

• External contamination of IV administration set injection ports is a significant issue.
• This contamination likely contributes to the bacterial load within IV infusates.
• Substandard care practices, such as inadequate water chlorination, may be contributing factors.