Endemic infusate contamination and related bacteremia.
BACKGROUND
Recent reports suggest that in-use contamination of intravenous infusates is uncommon in hospitals with good standards of care.


METHODS
We conducted a survey in a referral hospital in Mexico with good standards of care but no pharmacists to prepare intravenous infusates; we tested the a priori hypothesis that the contamination rate is zero. Using a sterile syringe, we took an initial infusate specimen at the time of recruitment, specimen 1, for culture. We took a second specimen, specimen 2, from administration sets that were maintained for 72 hours. Blood cultures were obtained at the discretion of the physicians caring for the patients.


RESULTS
We cultured 1093 infusate specimens from 621 administration sets comprising 421 patients. We obtained a specimen 1 from each of the enrolled sets and a specimen 2 from 472 sets (76%). We analyzed 10 significant cultures and obtained a global infusate contamination rate of 0.9% (10/1093; 95% CI: 0.5%-1.7%). Two cases of infusate-related bacteremia occurred, establishing a global rate of 0.003/72 infusion hours.


CONCLUSIONS
Even in institutions with good nursing standards, endemic in-use infusate contamination may be a present danger. We must avoid the use of intravenous therapy whenever possible.
Macias
Alejandro E
AE
National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico. aaeemmhh@yahoo.com
de Leon
Samuel Ponce
SP
Huertas
Martha
M
Maravilla
Ernesto
E
Romero
Carmen
C
Montoya
Thalpa G
TG
Muñoz
Juan M
JM
Lopez-Vidal
Yolanda
Y
D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004340:Drug Contamination; D006801:Humans; D007262:Infusions, Intravenous; D008800:Mexico / Q000453:epidemiology