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.
Subject(s)
Cross Infection/epidemiology , Disease Outbreaks , Drug Contamination , Endophthalmitis/epidemiology , Gram-Negative Bacterial Infections/epidemiology , Ophthalmic Solutions , Surgical Wound Infection/epidemiology , Aged , Aged, 80 and over , Burkholderia cepacia complex/classification , Burkholderia cepacia complex/genetics , Burkholderia cepacia complex/isolation & purification , Cluster Analysis , Cross Infection/microbiology , DNA Fingerprinting , Electrophoresis, Gel, Pulsed-Field , Endophthalmitis/microbiology , Genotype , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Middle Aged , Pseudomonas aeruginosa/classification , Pseudomonas aeruginosa/genetics , Pseudomonas aeruginosa/isolation & purification , Surgical Wound Infection/microbiology , Trypan BlueABSTRACT
We examined a cluster of 5 hemodialysis patients who contracted gram-negative bacteremia. A nurse who used an artificial fingernail to open a vial of heparin that was mixed to make a flush solution had a culture of an artificial fingernail specimen positive for Serratia marcescens. The typing of the S. marcescens strains isolated from the 5 patients and the nurse showed them to be identical. This finding provides strong support for policies prohibiting artificial nails for healthcare workers in all hemodialysis units.
Subject(s)
Bacteremia/transmission , Cross Infection/transmission , Infectious Disease Transmission, Professional-to-Patient/methods , Nails/microbiology , Renal Dialysis/adverse effects , Serratia Infections/transmission , Serratia marcescens/isolation & purification , Bacteremia/microbiology , Beauty Culture , Cross Infection/microbiology , DNA Fingerprinting , Hand Disinfection/methods , Humans , Infection Control/methods , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Infusions, Intravenous/adverse effects , Nursing Staff , Serratia Infections/microbiology , Serratia Infections/prevention & controlABSTRACT
We tested 100 keyboards in 29 clinical areas for bacterial contamination. Ninety five were positive for microorganisms. Streptococcus, Clostridium perfringens, Enterococcus (including one vancomycin-resistant Enterococcus), Staphylococcus aureus, fungi, and gram-negative organisms were isolated. Computer equipment must be kept clean so it does not become another vehicle for transmission of pathogens to patients.
