Infections and pseudoinfections due to povidone-iodine solution contaminated with Pseudomonas cepacia.
In 1989 we investigated the first instance of Pseudomonas cepacia infections due to intrinsic contamination of a povidone-iodine product. Six patients in a Texas pediatric facility had P. cepacia infection or pseudoinfection (three, peritonitis; one, pseudoperitonitis; and two, pseudobacteremia). Epidemiological studies showed one risk factor for infection of peritoneal fluid with P. cepacia: performance of peritoneal dialysis in the dialysis unit with use of one lot of povidone-iodine later found to be intrinsically contaminated (4/5 vs. 0/16, P = .001). Blood cultures yielded P. cepacia after nurses wiped the tops of blood culture bottles with the povidone-iodine solution before inoculation. P. cepacia was cultured from three povidone-iodine containers used at the hospital and from four containers of the same lot obtained from other health-care facilities in Texas and California. Isolates from patients and the povidone-iodine had similar antibiograms, identical plasmid profiles, and identical DNA banding patterns on the basis of results of ribonucleotide typing. This investigation demonstrates that intrinsic contamination of povidone-iodine solution with P. cepacia can result in infections in addition to colonization and/or pseudoinfection.
Panlilio
A L
AL
Investigation and Prevention Branch, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia.
Beck-Sague
C M
CM
Siegel
J D
JD
Anderson
R L
RL
Yetts
S Y
SY
Clark
N C
NC
Duer
P N
PN
Thomassen
K A
KA
Vess
R W
RW
Hill
B C
BC
D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology; D016956:Burkholderia cepacia / Q000145:classification / Q000254:growth & development / Q000302:isolation & purification*; D002675:Child, Preschool; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology*; D004196:Disease Outbreaks; D004340:Drug Contamination; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology; D011206:Povidone-Iodine / Q000009:adverse effects*; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology
D011206:Povidone-Iodine