title: Nosocomial outbreak of Pantoea agglomerans bacteraemia associated with contaminated anticoagulant citrate dextrose solution: new name, old bug?
abstract: We describe an outbreak investigation of Pantoea agglomerans bacteraemia associated with anticoagulant citrate-dextrose 46% (ACD) solution prepared in-house. A healthy man presented with septic shock during plasmapheresis for granulocyte donation. The solution used for priming and blood samples were sent for culture. Identification of the isolate to species level was performed by gyrB sequencing. Typing was performed by pulsed-field gel electrophoresis (PFGE). In total, eight cases were identified during a three-week period. P. agglomerans was also cultured from six ACD solution bags. Isolates from patients and ACD bags were identical by PFGE. All isolates were susceptible to ampicillin, cephazolin, gentamicin, ciprofloxacin, cefepime and imipenem.
authors.affiliation: Infection Control Department, Hospital das Clínicas, University of São Paulo, Brazil. icarobski@uol.com.br
authors.forename: I
authors.initials: I
authors.lastname: Boszczowski
authors.forename: J
authors.initials: J
authors.lastname: Nóbrega de Almeida Júnior
authors.forename: E J
authors.initials: EJ
authors.lastname: Peixoto de Miranda
authors.forename: M
authors.initials: M
authors.lastname: Pinheiro Freire
authors.forename: T
authors.initials: T
authors.lastname: Guimarães
authors.forename: C E
authors.initials: CE
authors.lastname: Chaves
authors.forename: D P
authors.initials: DP
authors.lastname: Cais
authors.forename: T M V
authors.initials: TM
authors.lastname: Strabelli
authors.forename: C F
authors.initials: CF
authors.lastname: Risek
authors.forename: R E
authors.initials: RE
authors.lastname: Soares
authors.forename: F
authors.initials: F
authors.lastname: Rossi
authors.forename: S F
authors.initials: SF
authors.lastname: Costa
authors.forename: A S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D015373:Bacterial Typing Techniques; D019343:Citric Acid; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D027081:DNA Gyrase / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology; D004866:Equipment Contamination; D005260:Female; D005947:Glucose / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020636:Pantoea / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: C002113:acid citrate dextrose; D019343:Citric Acid; D027081:DNA Gyrase; D005947:Glucose