Endemic infusate contamination and related bacteremia

Am J Infect Control. 2008 Feb;36(1):48-53. doi: 10.1016/j.ajic.2007.02.003.

Abstract

Background: Recent reports suggest that in-use contamination of intravenous infusates is uncommon in hospitals with good standards of care.

Methods: We conducted a survey in a referral hospital in Mexico with good standards of care but no pharmacists to prepare intravenous infusates; we tested the a priori hypothesis that the contamination rate is zero. Using a sterile syringe, we took an initial infusate specimen at the time of recruitment, specimen 1, for culture. We took a second specimen, specimen 2, from administration sets that were maintained for 72 hours. Blood cultures were obtained at the discretion of the physicians caring for the patients.

Results: We cultured 1093 infusate specimens from 621 administration sets comprising 421 patients. We obtained a specimen 1 from each of the enrolled sets and a specimen 2 from 472 sets (76%). We analyzed 10 significant cultures and obtained a global infusate contamination rate of 0.9% (10/1093; 95% CI: 0.5%-1.7%). Two cases of infusate-related bacteremia occurred, establishing a global rate of 0.003/72 infusion hours.

Conclusions: Even in institutions with good nursing standards, endemic in-use infusate contamination may be a present danger. We must avoid the use of intravenous therapy whenever possible.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Bacteria / classification
  • Bacteria / isolation & purification
  • Colony Count, Microbial
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Drug Contamination*
  • Humans
  • Infusions, Intravenous*
  • Mexico / epidemiology