title: An outbreak of postoperative gram-negative bacterial endophthalmitis associated with contaminated trypan blue ophthalmic solution.
abstract: We report 6 cases of postsurgical endophthalmitis due to gram-negative bacteria associated with contaminated trypan blue dye from a compounding pharmacy. Unopened trypan blue syringes yielded Pseudomonas aeruginosa and Burkholderia cepacia complex on culture, with pulsed-field gel electrophoresis patterns indistinguishable from patient isolates. Contamination of compounded medications should be considered when investigating outbreaks of postoperative endophthalmitis.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Sunensr@azdhs.gov
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sunenshine
authors.forename: Maureen
authors.initials: M
authors.lastname: Schultz
authors.forename: Mary G
authors.initials: MG
authors.lastname: Lawrence
authors.forename: Soo
authors.initials: S
authors.lastname: Shin
authors.forename: Bette
authors.initials: B
authors.lastname: Jensen
authors.forename: Sabiha
authors.initials: S
authors.lastname: Zubairi
authors.forename: Ann M
authors.initials: AM
authors.lastname: Labriola
authors.forename: Alicia
authors.initials: A
authors.lastname: Shams
authors.forename: Judith
authors.initials: J
authors.lastname: Noble-Wang
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Arduino
authors.forename: Fred
authors.initials: F
authors.lastname: Gordin
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D042602:Burkholderia cepacia complex / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D004340:Drug Contamination; D016521:Electrophoresis, Gel, Pulsed-Field; D009877:Endophthalmitis / Q000453:epidemiology* / Q000382:microbiology; D005838:Genotype; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D014343:Trypan Blue
chemical_list: D009883:Ophthalmic Solutions; D014343:Trypan Blue