Volume 15, Number 1—January 2009
CME ACTIVITY - Research
Sphingomonas paucimobilis Bloodstream Infections Associated with Contaminated Intravenous Fentanyl1
|Reference||Organism||Infection ( no. patients)||Mode of transmission||Location of outbreak|
|(3)||Serratia marcescens||Bloodstream infections (18)||Intravenous magnesium sulfate||California, New Jersey, North Carolina, New York, Massachusetts|
|(4)||S. marcescens||Meningitis, epidural abscess, or joint infection (11)*||Epidural or intra-articular injection of betamethasone||California|
|(6)||Burkholderia cepacia||Bloodstream infections and sepsis (2 pediatric patients)||Intravenous antibiotic-lock flush solution||Connecticut|
|(7)||Hepatitis C||Acute hepatitis C (16)||Injected radiopharmaceutical for myocardial perfusion study||3 clinics in Maryland|
|(8,10)||Pseudomonas fluorescens||Bloodstream infections (64)||Heparin/saline intravenous flush||Missouri, New York, Texas, Michigan, South Dakota|
|(9)||Exophiala dermatitidis||Meningitis (5)†||Epidural injection of methylprednisolone‡||2 pain management clinics in North Carolina|
*3 case-patients died.
†1 case-patient died.
‡Prepared by a compounding pharmacy in South Carolina and supplied to hospitals and clinics in 5 states.
- US Food and Drug Administration. Guidance for FDA staff and industry compliance policy guides manual; section 460.200; pharmacy compounding; 2002 [cited 2008 Mar 28]. Available from http://www.fda.gov/OHRMS/DOCKETS/98fr/02D-0242_gdl0001.pdf
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- Sunenshine RH, Tan ET, Terashita DM, Jensen BJ, Kacica MA, Sickbert-Bennett EE, A multistate outbreak of Serratia marcescens bloodstream infection associated with contaminated intravenous magnesium sulfate from a compounding pharmacy. Clin Infect Dis. 2007;45:527–33.
- Civen R, Vugia DJ, Alexander R, Brunner W, Taylor S, Parris N, Outbreak of Serratia marcescens infections following injection of betamethasone compounded at a community pharmacy. Clin Infect Dis. 2006;43:831–7.
- Perz JF, Craig AS, Stratton CW, Bodner SJ, Phillips WE Jr, Schaffner W. Pseudomonas putida septicemia in a special care nursery due to contaminated flush solutions prepared in a hospital pharmacy. J Clin Microbiol. 2005;43:5316–8.
- Held MR, Begier EM, Beardsley DS, Browne FA, Martinello RA, Baltimore RS, Life-threatening sepsis caused by Burkholderia cepacia from contaminated intravenous flush solutions prepared by a compounding pharmacy in another state. Pediatrics. 2006;118:e212–5.
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- Centers for Disease Control and Prevention. Pseudomonas bloodstream infections associated with a heparin/saline flush—Missouri, New York, Texas, and Michigan, 2004–2005. MMWR Morb Mortal Wkly Rep. 2005;54:269–72.
- Centers for Disease Control and Prevention. Exophiala infection from contaminated injectable steroids prepared by a compounding pharmacy—United States, July–Nov 2002. MMWR Morb Mortal Wkly Rep. 2002;51:1109–12.
- Centers for Disease Control and Prevention. Update: delayed onset Pseudomonas fluorescens bloodstream infections after exposure to contaminated heparin flush—Michigan and South Dakota, 2005–2006. MMWR Morb Mortal Wkly Rep. 2006;55:961–3.
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- Western States Medical Center v. Shalala, 238 F.3d 1090 (9th Cir. 2001).
- Thompson v. Western States Medical Center, 535 U.S. 357 (2002).
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1Data presented in part at the 18th Annual Meeting of the Society for Healthcare Epidemiology of America; Orlando, Florida; April 6, 2008 (abstract 478).