title: [Control of pediatric nosocomial bacteremia by a program based on culturing of parenteral solutions in use].
abstract: OBJECTIVE
  As Klebsiella, Enterobacter and Serratia are capable of growth in i.v. fluids and these bacteria are commonly implicated in nosocomial bacteremia, a control strategy through microbiological surveillance of in-use parenteral solutions is proposed.
  
  
  METHODS
  A second level general teaching hospital, serving low-income patients. Through four consecutive strategies, a continuous surveillance program of i.v. fluids sterility in pediatric wards was stablished in 1992. During the first stage all of the in-use solutions were cultured. During the second stage randomly selected samples were studied. Third stage was designed as a case-control study. The last stage included samples drawn in convenience. Positive cultures point out eventual infusion mishandling, as well as high-risk areas and patients.
  
  
  RESULTS
  After culturing 1940 parenteral solutions, infusion contamination rates decreased from 29.6% in 1992 to 12.9% in 1997 (p < 0.001). The proportion of Gram-negative rods isolated from blood cultures went from 72.7% to 40.85% (p < 0.0001), and the nosocomial bacteremia rate dropped from 3.12 to 1.54 per 100 discharges.
  
  
  CONCLUSIONS
  The program has enabled us to: 1) Detect and control eventual bacteremia outbreaks; 2) Assess the endemic infusion contamination rate; 3) Arouse healthcare workers awareness about infusion line precautions; 4) Have a suitable surveillance strategy according to our laboratory's workload.
authors.affiliation: Hospital General Regional de León, Guanajuato, México.
authors.forename: J M
authors.initials: JM
authors.lastname: Muñoz
authors.forename: A E
authors.initials: AE
authors.lastname: Macías
authors.forename: F J
authors.initials: FJ
authors.lastname: Guerrero
authors.forename: I
authors.initials: I
authors.lastname: Hernández
authors.forename: H
authors.initials: H
authors.lastname: Medina
authors.forename: E
authors.initials: E
authors.lastname: Vargas
mesh_terms: D016470:Bacteremia / Q000517:prevention & control*; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D016022:Case-Control Studies; D002648:Child; D003428:Cross Infection / Q000517:prevention & control*; D006784:Hospitals, Teaching; D006801:Humans; D008800:Mexico; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012996:Solutions / Q000009:adverse effects*
chemical_list: D012996:Solutions