TY - JOUR AU - Maragakis, Lisa AU - Chaiwarith, Romanee AU - Srinivasan, Arjun AU - Torriani, Francesca AU - Avdic, Edina AU - Lee, Andrew AU - Ross, Tracy AU - Carroll, Karen AU - Perl, Trish T1 - Sphingomonas paucimobilis Bloodstream Infections Associated with Contaminated Intravenous Fentanyl T2 - Emerging Infectious Disease journal PY - 2009 VL - 15 IS - 1 SP - 12 SN - 1080-6059 AB - Nationally distributed medications from compounding pharmacies, which typically adhere to less stringent quality-control standards than pharmaceutical manufacturers, can lead to multistate outbreaks. We investigated a cluster of 6 patients in a Maryland hospital who had Sphingomonas paucimobilis bloodstream infections in November 2007. Of the 6 case-patients, 5 (83%) had received intravenous fentanyl within 48 hours before bacteremia developed. Cultures of unopened samples of fentanyl grew S. paucimobilis; the pulsed-field gel electrophoresis pattern was indistinguishable from that of the isolates of 5 case-patients. The contaminated fentanyl lot had been prepared at a compounding pharmacy and distributed to 4 states. Subsequently, in California, S. paucimobilis bacteremia was diagnosed for 2 patients who had received intravenous fentanyl from the same compounding pharmacy. These pharmacies should adopt more stringent quality-control measures, including prerelease product testing, when compounding and distributing large quantities of sterile preparations. KW - Sphingomonas KW - outbreak KW - healthcare-associated infections KW - compounding pharmacy KW - research KW - United States DO - 10.3201/eid1501.081054 UR - https://wwwnc.cdc.gov/eid/article/15/1/08-1054_article ER - End of Reference