An Epidemic in a Coronary Care Unit Caused by Pseudomonas Species

Abstract

Five patients in a coronary care unit were involved in an epidemic caused by a nonfermenting Gram-negative bacillus, presumptively identified by our laboratory as Pseudomonas cepacia. All medications administered intravenously to these patients were cultured. Because morphine was the only such medication common to the treatment of all the patients involved, a vial used in the unit at that time was cultured, as were two previously-entered vials of saline solution and several sterile vials of distilled water used in the preparation of injectable medication. The Pseudomonas cepacia organism was recovered from one of the vials of saline solution. The epidemic ended as soon as the practice of re-entering the vials of sterile saline solution was discontinued.

Therapeutic options for Burkholderia cepacia infections beyond co-trimoxazole: a systematic review of the clinical evidence

“…Nine (15.8%) of 57 cases were treated with chloramphenicol, either as monotherapy in 4 cases (44.4%) [37,64,69,72] or as part of combination therapy with sulfisoxazole in 3 cases (33.3%) [4], sulfadiazine in 1 case (11.1%) [69] and tetracycline/kanamycin/nalidixic acid in the last case (11.1%) [66]. Six (66.7%) of them were cured and clinical improvement was noted in two (22.2%), one of whom died of a reason irrelevant to the infection.…”

“…All of the piperacillin recipients had a favourable outcome. Amoxicillin/clavulanic acid [45], ampicillin [37] and carbenicillin [63] were administered in one case each. Six (85.7%) of these patients were considered as cured, whilst one (14.3%) was reported as improved.…”

“…Cephalosporins other than ceftazidime were administered in six cases (10.5%); two patients received ceftriaxone [58,65], two received cefepime [41,55], one cefalothin combined with kanamycin [37] and one cefotetan with imipenem/tobramycin [39]. Four (66.7%) of these six patients were cured.…”

The epidemiology of nosocomial epidemic Pseudomonas cepacia infections

“…Nosocomial epidemics of P. cepacia bloodstream infections have been the subject of at least 15 separate reports involving a variety of different reservoirs and different modes of transmission (1,7,8,10,11,18,25,28,31,34,36,40,45,47,CDC unpublished data).…”

“…--Epidemic P. cepacia bloodstream In 2 investigations, intravenous products had become contaminated extrinsically (8,11). --Epidemic P. cepacia bloodstream In 2 investigations, intravenous products had become contaminated extrinsically (8,11).…”