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Pseudobacteremia due to Pseudomonas fluorescens.

A E Simor, J Ricci, A Lau

    Pediatric Infectious Disease
    |September 1, 1985
    PubMed
    Summary

    Pseudomonas fluorescens in blood cultures often indicates pseudobacteremia, not true infection. Contamination of collection tubes with sodium citrate solution led to false positives in pediatric patients.

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    Area of Science:

    • Clinical Microbiology
    • Infectious Diseases
    • Hospital Epidemiology

    Background:

    • Pseudomonas fluorescens is an opportunistic pathogen.
    • Bacteremia can lead to significant patient morbidity and mortality.
    • Pseudobacteremia, or false-positive blood cultures, can result from contamination during sample collection or processing.

    Purpose of the Study:

    • To investigate the cause of recurrent Pseudomonas fluorescens recovery from blood cultures in a pediatric hospital.
    • To determine if the P. fluorescens isolates were causing true bacteremia or pseudobacteremia.
    • To identify the source and mechanism of contamination.

    Main Methods:

    • Retrospective analysis of blood culture results and patient data.
    • Case-control study to identify risk factors associated with P. fluorescens recovery.
    • Review of venipuncture techniques and laboratory procedures.
    • Microbiological investigation of collection tubes and reagents.
    • In vitro growth studies of P. fluorescens in sodium citrate solutions.

    Main Results:

    • Pseudomonas fluorescens was recovered from 0.26% of blood cultures, with no associated patient illness.
    • A strong correlation was found between P. fluorescens recovery and concurrent coagulation studies.
    • Contamination originated from sodium citrate tubes used for coagulation studies, which supported P. fluorescens growth.
    • The source was traced to contaminated sodium citrate solutions used in the hospital.

    Conclusions:

    • The majority of P. fluorescens blood culture findings in this study represented pseudobacteremia.
    • Cross-contamination occurred due to the inoculation of blood culture bottles after contaminated citrated collection tubes.
    • Strict adherence to specimen collection protocols and reagent quality control is crucial to prevent pseudobacteremia.

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