Document Detail


Pseudooutbreak of Candida guilliermondii fungemia in a neonatal intensive care unit.
MedLine Citation:
PMID:  1766709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
During a 3-week period multiple blood cultures obtained from 14 Neonatal Intensive Care Unit infants and 3 Newborn Unit babies grew Candida guilliermondii, a yeast rarely associated with infections in humans. At the time of detection of positive cultures, most infants had been hospitalized for days or weeks for serious perinatal conditions and treated with antibiotics and intravenous hyperalimentation. Two critically ill premature infants from whom the yeast was isolated were given amphotericin B. In 7 other infants, however, yeasts were recovered on the day of birth, raising the question of pseudofungemia. Exhaustive interrogation on the blood culture practices revealed that when drawing blood for a culture from small infants, "butterfly" needles were often flushed with a diluted heparin solution to prevent blood clotting. Culture of a single lot of diluted heparin vials, prepared at the hospital pharmacy and distributed to the Neonatal Intensive Care Unit and Newborn Unit shortly before the onset of the epidemic, grew between 10,000 and 15,000 colony-forming units of Candida guilliermondii/ml. Removal of contaminated heparin vials and discontinuation of heparinization of needles used for blood cultures resulted in cessation of the epidemic. The present outbreak illustrates the difficulties in recognizing pseudoinfections in sick premature infants and the importance of intensive investigation and intervention during such an outbreak.
Authors:
P Yagupsky; R Dagan; M Chipman; A Goldschmied-Reouven; E Zmora; M Karplus
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  10     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-02-14     Completed Date:  1992-02-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  928-32     Citation Subset:  IM    
Affiliation:
Clinical Microbiology Laboratory, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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MeSH Terms
Descriptor/Qualifier:
Blood / microbiology
Blood Specimen Collection
Candidiasis / diagnosis*
Cross Infection / diagnosis
Disease Outbreaks
Drug Contamination
Fungemia / diagnosis*
Heparin
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Chemical
Reg. No./Substance:
9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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