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Enterobacter sepsis in infants and children due to contaminated intravenous fluids

N S Matsaniotis, V P Syriopoulou, M C Theodoridou

    Infection Control : IC
    |October 1, 1984
    PubMed

    Insights

    Nosocomial sepsis outbreaks in a pediatric hospital were linked to contaminated intravenous fluids. Investigations revealed bacterial contamination in the intravenous fluid bottle screw-caps, leading to patient infections and four deaths.

    Area of Science:

    • Infectious Diseases
    • Hospital Epidemiology
    • Microbiology

    Background:

    • Nosocomial sepsis poses a significant threat in pediatric healthcare settings.
    • Intravenous fluid administration is a common medical procedure with inherent risks.
    • Identifying sources of hospital-acquired infections is crucial for patient safety.

    Purpose of the Study:

    • To investigate the cause of a nosocomial sepsis outbreak in a pediatric hospital.
    • To identify the specific pathogen and source of contamination in intravenous fluids.
    • To determine the clinical impact of the outbreak on patient outcomes.

    Main Methods:

    • Epidemiologic investigation of 63 nosocomial sepsis cases.
    • Laboratory analysis to identify bacterial contaminants in intravenous fluids.
    • Traceback investigation to pinpoint the contamination site within the fluid delivery system.

    Main Results:

    • Sixty-three cases of nosocomial sepsis were traced to a single manufacturer's intravenous fluid.
    • Enterobacter cloacae and Enterobacter agglomerans were identified as the causative agents.
    • Contamination was localized to the screw-caps of the intravenous fluid bottles.
    • Four patient deaths, including vulnerable individuals, were potentially linked to these infections.

    Conclusions:

    • Contaminated intravenous fluids can cause significant nosocomial sepsis outbreaks.
    • Screw-cap contamination of intravenous fluid bottles is a potential route for pathogen transmission.
    • Vigilant examination of intravenous fluids is essential during unusual pathogen-related bacteremia outbreaks.

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