Pseudomonas species bacteremia caused by contaminated normal human serum albumin.

TitlePseudomonas species bacteremia caused by contaminated normal human serum albumin.
Publication TypeJournal Article
Year of Publication1977
AuthorsSteere AC, Tenney JH, Mackel DC, Snyder MJ, Polakavetz S, Dunne ME, Dixon R
JournalThe Journal of infectious diseases//J Infect Dis
Pagination729 - 35
Date Published1977
ISBN Number0022-1899
Other Numbersih3, 0413675
Keywords*Pseudomonas aeruginosa/ip [Isolation & Purification], *Sepsis/et [Etiology], *Serum Albumin/st [Standards], Chloramphenicol/pd [Pharmacology], Disease Outbreaks/pc [Prevention & Control], Drug Resistance, Microbial, Epidemiologic Methods, Humans, Nalidixic Acid/pd [Pharmacology], Pseudomonas aeruginosa/de [Drug Effects], Pseudomonas/de [Drug Effects], Pseudomonas/ip [Isolation & Purification], Tetracycline/pd [Pharmacology]

In May and June 1973, 11 patients on the surgical service at the University of Maryland Hospital had bacteremia caused by Pseudomonas species. Seven of the isolates recovered from blood cultures had the same antibiogram (sensitive only to chloramphenicol and tetracycline). Ten of the 11 patients were given 25% normal serum albumin (human) shortly before the onset of symptoms. In contrast, only two of seven patients with bacteremia due to Psuedomonas aeruginosa in May and June (P =0.013) and only nine of 20 patients located in surgical special care units during these months (P =0.014) were given this product. When cultured, the albumin in one of 54 previously unopened vials from the implicated lot yielded Pseudomonas cepacia sensitive only to chloramphenicol, tetracycline, and nalidixic acid. Subsequent investigation showed that five more patients in four other hospitals had symptoms of bacteremia shortly after the infusion of different lots of albumin from the same manufacturer, and in four cases P. cepacia was cultured from the suspect albumin. Since sterility testing by manufacturers may not detect low-frequency contamination, surveillance of nosocomial infections, investigation of unusual disease clusters, and prompt reporting of suspect reactions are essential in the control of such outbreaks.

Notify Library Reference ID4317

Related Incidents