Articles: sepsis.
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J. Clin. Microbiol. · Dec 1975
Nationwide epidemic of septicemia caused by contaminated intravenous products: mechanisms of intrinsic contamination.
Between 1 July 1970 and April 1971, in many hospitals in this country, there were outbreaks of nosocomial septicemia caused by Enterobacter cloacae of E. agglomerans (formerly Erwinia, herbicola-lathyri). All of these hospitals used infusion products manufactured by one company, Abbott Laboratories, and all affected patients had onset of septicemia while receiving the company's infusion products. ⋯ Investigations both in the laboratory and in the manufacturing plant into the mechanism of contamination of these products revealed the following. (i) Epidemic strains were present in numerous areas throughout the manufacturing plants. (ii) Viable microorganisms gained access to the interior of screw-cap closures after the autoclave step of production. (iii) Cooling closures actively drew moisture through the thread interstices into the inner-most depths of the closure. (iv) Transfer of contaminants from closures to fluid was easily effected by simple manipulations duplicating normal in-hospital use. (v) The red-rubber liner used in the company's screw-cap closures before the introduction of elastomer contained a broad-spectrum antimicrobial inhibitor. The findings from this epidemic and the associated studies show that the screw-cap closure as it is now designed cannot be considered secure for products that must remain sterile.
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Dtsch. Med. Wochenschr. · Nov 1975
[Contaminated infusions as cause of nosocomial Serratia marcescens septicaemia in children (author's transl)].
At the University Children's Clinic at Munich 25 cases of Serratia marescens septicaemia (mainly bacteriocin types 18 and 44) occurred within one year, predominantly in newborns and infants. Almost all of the children were seriously ill from an underlying illness or had been operated on. ⋯ Main source of the septicaemia were contaminated infusions, from which in as many as 35% of cases microorganisms, usually Serratia marcescens, had been isolated. Intensive hygienic measures at once terminated this "sepsis wave".
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Four cases of septicaemia in children were traced to contaminated intravenous infusions and volume control sets. In each case Pseudomonas cepacia was isolated from multiple blood cultures and from intravenous fluid within the volume control set. The first patient died of septicaemia after a long and complicated postoperative period. The other three patients received appropriate antibiotics after removal of the contaminated intravenous sets and they recovered within 2 weeks.