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Pseudomonas aeruginosa peritonitis associated with contaminated poloxamer-iodine solution
Abstract:
Pseudomonas aeruginosa was responsible for four cases of peritonitis and one of wound infection at the catheter site in outpatients on chronic peritoneal dialysis. All organisms had the same antimicrobial susceptibilities and serotype. Culture surveys showed that a strain of Ps. aeruginosa of identical susceptibility pattern, plasmid profile, and serotype was present in bottles of a poloxamer-iodine solution unopened until the time of culture. Both poloxamer-iodine and povidone-iodine solutions have now been shown to be vulnerable to bacterial contamination. Guidelines for their production and use must be reassessed to take this possibility into account.
Insights
Contaminated poloxamer-iodine solutions caused Pseudomonas aeruginosa infections in chronic peritoneal dialysis patients. This highlights the vulnerability of antiseptic solutions to bacterial contamination, requiring reassessment of production and usage guidelines.
Area of Science:
- Infectious Diseases
- Microbiology
- Nephrology
Background:
- Pseudomonas aeruginosa infections pose a risk to patients undergoing chronic peritoneal dialysis.
- Antiseptic solutions are commonly used in medical settings, but their contamination potential is a concern.
Purpose of the Study:
- To investigate the source of Pseudomonas aeruginosa infections in outpatients on chronic peritoneal dialysis.
- To determine the potential for bacterial contamination in antiseptic solutions used in dialysis care.
Main Methods:
- Clinical case identification of Pseudomonas aeruginosa infections (peritonitis and wound infections).
- Microbiological culturing and characterization of bacterial isolates from patients and antiseptic solutions.
- Analysis of antimicrobial susceptibilities, serotypes, and plasmid profiles of Pseudomonas aeruginosa strains.
Main Results:
- Four cases of peritonitis and one wound infection were linked to Pseudomonas aeruginosa in dialysis patients.
- The causative strain of Pseudomonas aeruginosa was identical in patients and in unopened bottles of a poloxamer-iodine solution.
- Both poloxamer-iodine and povidone-iodine solutions demonstrated vulnerability to bacterial contamination.
Conclusions:
- Unopened poloxamer-iodine solutions can harbor Pseudomonas aeruginosa, serving as a source of infection for dialysis patients.
- The findings necessitate a critical review of manufacturing and handling protocols for antiseptic iodine-based solutions.
- Revised guidelines are crucial to prevent bacterial contamination and ensure patient safety in chronic peritoneal dialysis.