title: Nosocomial pediatric bacteremia: the role of intravenous set contamination in developing countries.
abstract: OBJECTIVE
  To assess the rate of bacterial contamination of intravenous administration sets at their rubber injection ports and matching infusates.
  
  
  METHODS
  Cultures of injection ports and infusate during 26 visits to 4 hospitals.
  
  
  METHODS
  Four public general pediatric hospitals in Mexico City with substandard care practices.
  
  
  METHODS
  Hospitalized pediatric patients receiving intravenous solutions.
  
  
  RESULTS
  Overall, 176 of 251 injection ports were contaminated (70.1%; 95% confidence interval [CI95], 64.5% to 75.8%), 35 (13.9%; CI95, 9.7% to 18.2%) with gram-negative rods, primarily of the tribe Klebsielleae. Cultures of infusates were positive in 17 cases (6.8%, CI95, 3.7% to 9.9%), 5 of which grew gram-negative rods (2%; CI95, 0.6% to 4.6%). In 3 cases (1.2%), the same species with gram-negative rods was found in the infusates and on the injection ports. During one visit, 8 clustered cases of injection port contamination with a clonal Enterobacter cloacae were found; this agent was also found in the blood culture, intravenous fluid, and parenteral nutrition of one patient. Inadequate chlorination of tap water, a potential risk factor, was recorded during 22 visits (84.6%).
  
  
  CONCLUSIONS
  These data suggest that external contamination of the intravenous administration set could play a role in infusate contamination.
authors.affiliation: University of Guanajuato School of Medicine at Leon, Leon, Mexico.
authors.forename: Alejandro E
authors.initials: AE
authors.lastname: Macías
authors.forename: Juan M
authors.initials: JM
authors.lastname: Muñoz
authors.forename: Laura E
authors.initials: LE
authors.lastname: Herrera
authors.forename: Humberto
authors.initials: H
authors.lastname: Medina
authors.forename: Isabel
authors.initials: I
authors.lastname: Hernández
authors.forename: Dolores
authors.initials: D
authors.lastname: Alcántar
authors.forename: Samuel
authors.initials: S
authors.lastname: Ponce de León
mesh_terms: D017848:Blood-Borne Pathogens; D002408:Catheters, Indwelling / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D003906:Developing Countries; D004196:Disease Outbreaks / Q000517:prevention & control; D016521:Electrophoresis, Gel, Pulsed-Field; D004866:Equipment Contamination; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006776:Hospitals, Pediatric; D006779:Hospitals, Public; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D008800:Mexico; D014871:Water Microbiology