Pseudomonas Septicemia Due to Deficient Disinfectant Mixing during Reuse

Abstract

We describe a cluster of four septicemias with pseudomonas, that occurred in a unit performing formaldehyde reuse of capillary dialyzers. Samples of blood, heparin solutions, dialysate and effluent of reused dialyzers, were evaluated bacteriologically and upon the adequacy of the reuse procedure. Pseudomonas aeruginosa, vesicularis and/or xanthomonas maltophilia were found on the blood cultures obtained during the septicemic reactions, and in the effluent of two reprocessed dialyzers not yet used (greater than 10(4) CFU/ml). These two dialyzers had also extremely low formaldehyde concentrations (0.0014 and 0.005% versus the expected 4%). Membrane and antibiogram characteristics of a Pseudomonas aeruginosa strain, recovered from the blood cultures in one patient, and of a strain found in the effluent of one of the two contaminated reprocessed dialyzers, were the same. The problem was attributed to the inadequate mixing of the disinfectant with the tap water used in the automated reprocessing device, in the absence of an alarm disclosing this failure.

Invasive Brevundimonas vesicularis bacteremia: Two case reports and review of the literature

“…4e16 Infections included bacteremia (10 cases), cutaneous infections (two cases), meningitis (one case), peritonitis (one case) and septic arthritis (one case). These patients were immunocompromised because of endstage renal disease, 10,11,14 systemic lupus erythematosus involving prolonged steroid use, 4 sickle cell anemia, 5 hematological malignancy 8 and neutropenia. The incidence of bloodstream infections of B. vesicularis in immunocompromised as well as immunocompetent patients is increasing ( Table 1).…”

Outbreaks Associated with Contaminated Antiseptics and Disinfectants

“…Formaldehyde inactivates microorganisms by alkylating the amino and sulfhydryl groups of proteins and the ring nitrogen atoms of purine bases. The aqueous solution (64), while an outbreak of Pseudomonas sepsis due to deficient formaldehyde mixing used to disinfect dialyzers was reported (88). Phenolics.…”

Use of Random Amplified Polymorphic DNA PCR To Examine Epidemiology of Stenotrophomonas maltophilia and Achromobacter ( Alcaligenes ) xylosoxidans from Patients with Cystic Fibrosis

“…Both organisms have been isolated from hospital sources, and they have been increasingly recognized as nosocomial pathogens, particularly for immunocompromised patients (7,13,14,19,22,31,38,41). Recent evidence suggests that they may also be emerging pathogens in cystic fibrosis (CF) patients (1,4,6,9,12,28).…”