Sphingomonaspaucimobilis Bloodstream Infections Associated with Contaminated Intravenous Fentanyl1
Published Date:Jan 2009
Source:Emerg Infect Dis. 15(1):12-18.
Electrophoresis, Gel, Pulsed-Field
Gram-Negative Bacterial Infections
Funding:1 K01 CI000300/CI/NCPDCID CDC HHS/United States
1 R01 CI000530/CI/NCPDCID CDC HHS/United States
Description:Nationally distributed medications from compounding pharmacies, which typically adhere to less stringent quality-control standards than pharmaceutical manufacturers, can lead to multistate outbreaks. We investigated a cluster of 6 patients in a Maryland hospital who had Sphingomonas paucimobilis bloodstream infections in November 2007. Of the 6 case-patients, 5 (83%) had received intravenous fentanyl within 48 hours before bacteremia developed. Cultures of unopened samples of fentanyl grew S. paucimobilis; the pulsed-field gel electrophoresis pattern was indistinguishable from that of the isolates of 5 case-patients. The contaminated fentanyl lot had been prepared at a compounding pharmacy and distributed to 4 states. Subsequently, in California, S. paucimobilis bacteremia was diagnosed for 2 patients who had received intravenous fentanyl from the same compounding pharmacy. These pharmacies should adopt more stringent quality-control measures, including prerelease product testing, when compounding and distributing large quantities of sterile preparations.
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