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Outbreak of Acinetobacter baumannii bacteremia related to contaminated morphine used for patient-controlled analgesia

Hsin-Chun Lee1, Nan-Yao Lee, Chia-Ming Chang

  • 1Department of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.

Infection Control and Hospital Epidemiology
|September 11, 2007
PubMed

Insights

A hospital outbreak of Acinetobacter baumannii bacteremia was linked to contaminated patient-controlled analgesia. Proper morphine solution preparation halted the spread of this postoperative infection.

Area of Science:

  • Infectious Disease Epidemiology
  • Hospital-Acquired Infections
  • Microbiology

Background:

  • Postoperative febrile episodes and Acinetobacter baumannii bacteremia occurred in obstetrics and gynecology wards.
  • An electrical blackout and water supply loss preceded the outbreak.

Purpose of the Study:

  • To investigate the cause of a cluster of postoperative febrile episodes and Acinetobacter baumannii bacteremia.
  • To identify the source and transmission route of the bacterial outbreak.

Main Methods:

  • Epidemiological investigation of patient cases.
  • Microbiological analysis of clinical isolates and medication solutions.
  • Genetic relatedness analysis of Acinetobacter baumannii isolates.

Main Results:

  • Patient-controlled analgesia was the sole independent risk factor for postoperative fever.
  • Acinetobacter baumannii isolates from patients were genetically linked to the diluted morphine solution.
  • The outbreak ceased after the identified issue with morphine solution preparation was corrected.

Conclusions:

  • Contaminated patient-controlled analgesia solution was the source of the Acinetobacter baumannii outbreak.
  • Proper medication preparation protocols are crucial for preventing hospital-acquired infections.
  • Interruption of essential services like water supply may increase infection risks.

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