title: Infections and pseudoinfections due to povidone-iodine solution contaminated with Pseudomonas cepacia.
abstract: 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.
authors.affiliation: Investigation and Prevention Branch, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia.
authors.forename: A L
authors.initials: AL
authors.lastname: Panlilio
authors.forename: C M
authors.initials: CM
authors.lastname: Beck-Sague
authors.forename: J D
authors.initials: JD
authors.lastname: Siegel
authors.forename: R L
authors.initials: RL
authors.lastname: Anderson
authors.forename: S Y
authors.initials: SY
authors.lastname: Yetts
authors.forename: N C
authors.initials: NC
authors.lastname: Clark
authors.forename: P N
authors.initials: PN
authors.lastname: Duer
authors.forename: K A
authors.initials: KA
authors.lastname: Thomassen
authors.forename: R W
authors.initials: RW
authors.lastname: Vess
authors.forename: B C
authors.initials: BC
authors.lastname: Hill
mesh_terms: 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
chemical_list: D011206:Povidone-Iodine