Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-13T01:00:06.735Z Has data issue: false hasContentIssue false

Epidemiologic Investigation of a 2007 Outbreak of Serratia marcescens Bloodstream Infection in Texas Caused by Contamination of Syringes Prefilled With Heparin and Saline

Published online by Cambridge University Press:  02 January 2015

John R. Su*
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia Texas Department of State Health Services, Austin, Texas
David B. Blossom
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Wendy Chung
Affiliation:
Dallas County Department of Health and Human Services, Dallas, Texas
Jessica Smartt Gullion
Affiliation:
Denton County Health Department, Denton, Texas
Neil Pascoe
Affiliation:
Texas Department of State Health Services, Austin, Texas
Gary Heseltine
Affiliation:
Texas Department of State Health Services, Austin, Texas
Arjun Srinivasan
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
*
Centers for Disease Control and Prevention, 1600 Clifton Rd MS-E02, Atlanta, GA 30333 (john.su@cdc.hhs.gov)

Abstract

This retrospective cohort study found that syringes prefilled with heparin flush solution caused an outbreak of Serratia marcescens bloodstream infection at an outpatient treatment center in Texas in 2007. The epidemiologic study supported this conclusion, despite the lack of microbiologic evidence of contamination from environmental and product testing. This report underscores the crucial contributions that epidemiologic studies can make to investigations of outbreaks that are possibly product related.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Donnenberg, MS. Enterobacteriaceae. In: Mandeli, GL, Bennett, JE, Dolin, R, ed. Principles and Practice of Infectious Diseases. 6th ed. Vol. 2. Philadelphia, PA: Elsevier Churchill Livingstone; 2005:25672586.Google Scholar
2.Jones, BL, Gorman, LJ, Simpson, J, et al.An outbreak of Serratia marcescens in two neonatal intensive care units. J Hosp Infect 2000;46:314319.CrossRefGoogle ScholarPubMed
3.Sunenshine, RH, Tan, ET, Terashita, DM, et al.A multistate outbreak of Serratiaa marcescens bloodstream infection associated with contaminated intravenous magnesium sulfate from a compounding pharmacy. Clin Infect Dis 2007;45:527533.CrossRefGoogle ScholarPubMed
4.Siegman-Igra, Y, Jacobi, E, Lang, R, et al.Unexpected hospital-acquired bacteraemia in patients at low risk of bloodstream infection: the role of a heparin drip. J Hosp Infect 2005;60:122128.CrossRefGoogle ScholarPubMed
5.Tanaka, T, Takahashi, H, Kobayashi, JM, et al.A nosocomial outbreak of febrile bloodstream infection caused by heparinized-saline contaminated with Serratia marcescens, Tokyo, 2002. Jpn J Infect Dis 2004;57:189192.Google ScholarPubMed
6.Knowles, S, Herra, C, Devitt, E, et al.An outbreak of multiply resistant Serratia marcescens: the importance of persistent carriage. Bone Marrow Transplant 2000;25:873877.CrossRefGoogle ScholarPubMed
7.Labarca, JA, Trick, WE, Peterson, CL, et al.A multistate nosocomial outbreak of Ralstonta pickettii colonization associated with an intrinsically contaminated respiratory care solution. Clin Infect Dis 1999;29:12811286.CrossRefGoogle ScholarPubMed
8.Blossom, D, Su, J, Pur, S, et al.Multistate outbreak of Serratia marcescens due to contamination of prefilled heparin and saline syringes. In: Program and abstracts of the 18th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America (SHEA). Arlington, VA: SHEA, 2008: Abstract 385.Google Scholar
9.United States Food and Drug Administration. AM2 PAT, Inc., issues nationwide recall of pre-filled heparin lock flush solution USP (5 mL in 12 mL syringes). Available at: http://www.fda.gov/oc/po/firmrecalls/am2patl2_07.html. Accessed April 10, 2009.Google Scholar
10.Bond, WW, Sehulster, LM. Microbiological assay of environmental and medical device surfaces. In: Isenberg, HD, ed. Clinical Microbiology Procedures Handbook. 2nd ed. Washington, DC: American Society for Microbiology Press; 2004:13.10.113.10.12.Google Scholar