title: Outbreak of Acinetobacter baumannii bacteremia related to contaminated morphine used for patient-controlled analgesia.
abstract: We investigated a cluster of postoperative febrile episodes and episodes of Acinetobacter baumannii bacteremia in obstetrics and gynecology wards after an electrical blackout and loss of the water supply. The use of patient-controlled analgesia was the only independent risk factor associated with postoperative fever, and A. baumannii isolates recovered from the blood of patients who had received patient-controlled analgesia were genetically related to an isolate recovered from the diluted morphine solution used for this procedure. After inappropriate preparation of the morphine solution was identified and stopped, the outbreak ended.
authors.affiliation: Department of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Hsin-Chun
authors.initials: HC
authors.lastname: Lee
authors.forename: Nan-Yao
authors.initials: NY
authors.lastname: Lee
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Cheng-Yang
authors.initials: CY
authors.lastname: Chou
authors.forename: Yi-Hui
authors.initials: YH
authors.lastname: Wu
authors.forename: Li-Rong
authors.initials: LR
authors.lastname: Wang
authors.forename: Nai-Ying
authors.initials: NY
authors.lastname: Ko
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Liu
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000209:etiology*; D040981:Acinetobacter baumannii / Q000472:pathogenicity*; D000328:Adult; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000009:adverse effects*; D016022:Case-Control Studies; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D004340:Drug Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects*; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D013624:Taiwan / Q000453:epidemiology; D014881:Water Supply / Q000032:analysis