Enterobacter cloacae sepsis outbreak in a newborn unit caused by contaminated total parenteral nutrition solution

被引:56
作者
Tresoldi, AT [1 ]
Padoveze, MC [1 ]
Trabasso, P [1 ]
Veiga, JFS [1 ]
Marba, STM [1 ]
von Nowakonski, A [1 ]
Branchini, MLM [1 ]
机构
[1] Univ Estadual Campinas, Fac Med Sci, Nosocomial Infect Control Comm, BR-13081970 Campinas, SP, Brazil
关键词
D O I
10.1067/mic.2000.105286
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: The study aimed to investigate an outbreak caused by Enterobacter cloacae in a neonate intensive care unit. Design: A descriptive study of an outbreak of sepsis in high-risk neonates was used. Setting: The study was set in a tertiary care university teaching hospital. Patients: The patients were 11 neonates infected with Enterobacter cloacae whose symptoms and signs of sepsis developed during a 16-hour period. All but one neonate received parenteral nutrition. Isolates from blood cultures, in-use parenteral nutrition solutions, and control aliquots of parenteral nutrition solution were typed by pulsed-field gel electrophoresis. Results: Enterobacter cloacae was found in the refrigerated aliquots of parenteral nutrition solution, in blood cultures from infected newborns, and from in-use parenteral nutrition solutions. All these strains of Enterobacter cloacae had the same antibiotic susceptibility pattern and the same genomic DNA profile. The strain isolated from the one patient who did not receive parenteral nutrition presented a different susceptibility profile and genotype. Conclusion: The source of the nosocomial sepsis was the parenteral nutrition solution in 10 neonates. This contamination apparently occurred during preparation of the parenteral solution.
引用
收藏
页码:258 / 261
页数:4
相关论文
共 24 条
[1]   Enterobacter cloacae and Pseudomonas aeruginosa polymicrobial bloodstream infections traced to extrinsic contamination of a dextrose multidose vial [J].
Archibald, LK ;
Ramos, M ;
Arduino, MJ ;
Aguero, SM ;
Deseda, C ;
Banerjee, S ;
Jarvis, WR .
JOURNAL OF PEDIATRICS, 1998, 133 (05) :640-644
[2]  
Centers for Disease Control and Prevention (CDC), 1998, MMWR Morb Mortal Wkly Rep, V47, P610
[3]   THE GROWTH OF MICROORGANISMS IN TOTAL PARENTERAL-NUTRITION ADMIXTURES [J].
DANGIO, R ;
QUERCIA, RA ;
TREIBER, NK ;
MCLAUGHLIN, JC ;
KLIMEK, JJ .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1987, 11 (04) :394-397
[4]  
DONOWITZ LG, 1993, PREVENTION CONTROL N, P796
[5]   SEPTICEMIA CAUSED BY CONTAMINATED PARENTERAL-NUTRITION POUCHES - THE REFRIGERATOR AS AN UNUSUAL CAUSE [J].
DUGLEUX, G ;
LECOUTOUR, X ;
HECQUARD, C ;
OBLIN, I .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1991, 15 (04) :474-475
[6]   THE INCIDENCE AND CLINICAL-SIGNIFICANCE OF INTRAVENOUS FAT EMULSION CONTAMINATION DURING INFUSION [J].
EBBERT, ML ;
FARRAJ, M ;
HWANG, LT .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1987, 11 (01) :42-45
[7]   Risk factors for Enterobacter septicemia in a neonatal unit: Case-control study [J].
Fok, TF ;
Lee, CH ;
Wong, EMC ;
Lyon, DJ ;
Wong, W ;
Ng, PC ;
Cheung, KL ;
Cheng, AFB .
CLINICAL INFECTIOUS DISEASES, 1998, 27 (05) :1204-1209
[8]   SEPSIS DURING TOTAL PARENTERAL-NUTRITION [J].
FREUND, HR ;
RIMON, B .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1990, 14 (01) :39-41
[9]   MICROBIAL-GROWTH PATTERNS IN A TOTAL PARENTERAL-NUTRITION FORMULATION CONTAINING LIPID EMULSION [J].
GILBERT, M ;
GALLAGHER, SC ;
EADS, M ;
ELMORE, MF .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1986, 10 (05) :494-497
[10]   RAPID FIELD INVERSION GEL-ELECTROPHORESIS IN COMBINATION WITH AN RIBOSOMAL-RNA GENE PROBE IN THE EPIDEMIOLOGIC EVALUATION OF STAPHYLOCOCCI [J].
GOERING, RV ;
DUENSING, TD .
JOURNAL OF CLINICAL MICROBIOLOGY, 1990, 28 (03) :426-429