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Sepsis arising from extrinsic contamination of the infusion and measures for control

  • Chapter
Microbiological Hazards of Infusion Therapy

Abstract

Outbreaks of nosocomial septicaemia traced to intrinsic contamination of infusion products in the US and Great Britain between 1970 and 19731-8 have focused unprecedented attention on the iatrogenic hazards of infusion therapy, and particularly on septicaemia arising from contaminated fluid. Yet, the total number of cases identified in these outbreaks comprise but a fraction of all infusion-related septicaemias occurring in hospitals. Fortunately, commercially manufactured parenteral products which are alleged to be sterile almost inevitably are, and intrinsic contamination is exceedingly rare. The vast majority of infections associated with infusion therapy derive from extrinsic sources of contamination, with micro organisms introduced into a previously sterile infusion or the cannula wound during therapy.

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References

  1. Center for Disease Control. (1971). Nosocomial bacteremias associated with intravenous fluid therapy-USA. Morbid. Mortal. Weekly Rep. ,20 (Suppl.)

    Google Scholar 

  2. Felts, S. K., Shaffner, W., Melly, M. A. and Koenig, M. G. (1972). Sepsis caused by contaminated intravenous fluids: epidemiologic, clinical and laboratory investigations of an outbreak in one hospital. Ann. Intern. Med., 11 ,881

    Google Scholar 

  3. Fisher, E. J., Maki, D. G., Eisses, J. and Quinn, E. (1971). Epidemic septicemias due to intrinsically contaminated infusion products. Abstracts of papers presented at the Eleventh Interscience Conference for Anti microbial Agents and Chemotherapy. October 20, Atlantic City

    Google Scholar 

  4. Maki, D. G., Rhame, F. S., Mackel, D. C. and Bennett, J. V. (1976). Nationwide epidemic of septicemia caused by contaminated intravenous products: epidemiologic and clinical features. Am. J. Med. ,60, 471

    Article  PubMed  CAS  Google Scholar 

  5. Phillips, I., Eykyn, S. and Laker, M. (1972). Outbreak of hospital infection caused by contaminated autoclaved fluids. Lancet ,i, 1258

    Article  Google Scholar 

  6. Meers, P. D., Calder, M. W., Mazhar, M. M. and Lawrie, G. M. (1973). Intravenous infusion of contaminated dextrose solution. Lancet ,ii, 1189

    Article  Google Scholar 

  7. Center for Disease Control. (1973). Septicemias associated with contam inated intravenous fluids. Morbid. Mortal. Weekly Rep. ,22, 99

    Google Scholar 

  8. Maki, D. G., Goldmann, D. A. and Rhame, F. S. (1973). Infection control in intravenous therapy. Ann. Intern. Med. ,79, 867

    PubMed  CAS  Google Scholar 

  9. Druskin, M. S. and Siegel, P. D. (1963). Bacterial contamination of indwelling intravenous polyethylene catheters. J. Am. Med. Ass. ,185, 966

    Article  CAS  Google Scholar 

  10. Moran, J. M., Atwood, R. P. and Rowe, M. I. (1965). A clinical and bacteriologic study of infections associated with venous cut-downs. N. Engl. J. Med. ,272, 554

    Article  PubMed  CAS  Google Scholar 

  11. Smits, H. and Freedman, I. R. (1967). Prolonged venous catheterization as a cause of sepsis. N. Engl. J. Med. ,276, 1229

    Article  PubMed  CAS  Google Scholar 

  12. Bernard, R. W., Stahl, W. M. and Chase, R. M. (1971). Subclavian vein catheterizations: A prospective study. II. Infectious complications. Ann. Surg. ,173, 191

    Article  PubMed  CAS  Google Scholar 

  13. Henzel, J. H. and DeWeese, M. S. (1971). Morbid and mortal complications associated with prolonged central venous cannulation. Am. J. Surg. ,121, 600

    Article  PubMed  CAS  Google Scholar 

  14. Mogensen, J. V., Frederiksen, W. and Jensen, J. K. (1972). Subclavian vein catheterization and infection: A bacteriologic study of 130 catheter insertions. Scand. J. Infect. Dis. ,4, 31

    PubMed  CAS  Google Scholar 

  15. Colvin, M. P., Blogg, C. E., Savege, T. M. et al. (1972). A safe long-term infusion technique? Lancet ,ii, 317

    Article  Google Scholar 

  16. Hoshal, V. L. (1972). Intravenous catheters and infection. Surg. Clin. N. Am. ,52, 1407

    PubMed  Google Scholar 

  17. Francke, D. E. (editor). (1970). Handbook of IV Additive Reviews ,p. 18 (Hamilton, Illinois: Hamilton Press)

    Google Scholar 

  18. Hoshal, V. L., Ause, R. G. and Hoskins, P. A. (1971). Fibrin sleeve formation on indwelling subclavian central venous catheters. Arch. Surg. ,102, 253

    Google Scholar 

  19. Peters, W. R., Bush, W. H., Mclntyre, R. D. and Hill, L. D. (1973). The development of fibrin sheath on indwelling venous catheters. Surg. Gynecol. Obstet. ,137, 43

    PubMed  CAS  Google Scholar 

  20. Turco, S. J. (1975). Phlebitis associated with intravenous drug administration. Bull. Paren. Drug Assoc. ,29, 89

    CAS  Google Scholar 

  21. Maki, D. G., Weise, C. E. and Sarafìn, H. W. (1976). Semi-quantitative method for identifying intravenous catheter-related infection. Clin. Res. ,24, 25A

    Google Scholar 

  22. Pollack, M., Charache, P., Nieman, R. E., Jett, M. P., Reinhardt, J. A. and Hardy, P. H. Jr. (1972). Factors influencing colonization and antibiotic-resistant patterns of Gram-negative bacteria in hospital patients. Lancet ,ii, 668

    Article  Google Scholar 

  23. Salzman, T. C., Clark, J. J. and Klemm, L. (1968). Hand contamination of personnel as a mechanism of cross-infection in nosocomial infections with antibiotic-resistant Escherichia coli and Klebsiella-Aerobacter. Antimicrob. Agents Chemother. ,1967, 97

    Google Scholar 

  24. Knittle, M. A., Eitzman, D. V. and Baer, J. (1975). Role of hand contamination of personnel in epidemiology of Gram-negative nosocomial infections. J. Pediatr. ,86, 433

    Article  PubMed  CAS  Google Scholar 

  25. Brereton, R. B. (1969). Incidence of complications from indwelling venous catheters. Del. Med. J. ,41, 1

    Google Scholar 

  26. Banks, D. C, Yates, D. B., Cawdrey, H. M. et al. (1970). Infection from intravenous catheters. Lancet ,i, 443

    Article  Google Scholar 

  27. Darrell, J. H. and Garrod, L. P. (1969). Secondary septicaemia from intravenous cannulae. Br. Med. J. ,2, 481

    Article  PubMed  CAS  Google Scholar 

  28. Roberts, R. J. and Cockcroft, W. H. (1970). Infection associated with intravenous catheters. Can. Med. Ass. J. ,102, 89

    PubMed  CAS  Google Scholar 

  29. Morse, L. J., Williams, H. L., Grenn, F. P. et al. (1967). Septicemia due to Klebsiella pneumoniae originating from a hand cream dispenser. N. Engl. J. Med. ,277, 472

    Article  PubMed  CAS  Google Scholar 

  30. Lowbury, E. J. L., Lilly, H. A. and Bull, J. P. (1964). Methods for disinfection of hands and operation sites. Br. Med. J. ,2, 531

    Article  PubMed  CAS  Google Scholar 

  31. White, J. J., Wallace, C. K. and Burnett, L. S. (1970). Skin disinfection. Johns Hopkins Med. J. ,126, 169

    PubMed  CAS  Google Scholar 

  32. Plotkin, S. A. and Austrian, R. (1958). Bacteremia caused by Pseudomonas sp. following the use of materials stored in solutions of a cationic surfaceactive agent. Am. J. Med. Sci. ,235, 621

    Article  PubMed  CAS  Google Scholar 

  33. Malizia, W. F., Gangarosa, E. J. and Goley, A. F. (1960). Benzalkonium chloride as a source of infection. N. Engl. J. Med. ,263, 800

    Article  PubMed  CAS  Google Scholar 

  34. Sack, R. A. (1970). Epidemic of Gram-negative organism septicemia subsequent to elective operation. Am. J. Obstet. Gynecol. ,107, 394

    PubMed  CAS  Google Scholar 

  35. Phillips, I., Eykyn, S., Curtis, M. A. and Snell, J. J. S. (1971). Pseudomonas cepacia (multivorans) septicemia in an intensive care unit. Lancet ,i, 375

    Article  Google Scholar 

  36. Speller, D. C. E., Stephens, M. E. and Viant, A. C. (1971). Hospital infection by Pseudomonas cepacia. Lancet ,i, 798

    Article  Google Scholar 

  37. Stamm, W. E., Colella, J. J., Anderson, R. L. and Dixon, R. E. (1975). Indwelling arterial catheters as a source of nosocomial bacteremia. N. Engl. J. Med. ,292, 1099

    Article  PubMed  CAS  Google Scholar 

  38. Center for Disease Control. (1974). Nosocomial Pseudomonas cepacia bacteremia caused by contaminated pressure transducers. Morbid. Mortal. Weekly Rep. ,23, 423

    Google Scholar 

  39. Center for Disease Control. (1975). Transducer-associated bacteremia. Morbid. Mortal. Weekly Rep. ,24, 295

    Google Scholar 

  40. Primary Bacteremia-Illinois. (1976). Morbid. Mortal. Weekly Rep. ,25, 110

    Google Scholar 

  41. Lee, J. C. and Fiaklow, P. J. (1961). Benzalkonium chloride-ource of hospital infection with Gram-negative bacteria. J. Am. Med. Ass., 177 ,708

    Article  CAS  Google Scholar 

  42. Bassett, D. C. J. (1971). The effect of pH on the multiplication of a pseudomonad in chlorhexidine and cetrimide. J. Clin. Pathol. ,24, 708

    Article  PubMed  CAS  Google Scholar 

  43. Lowenbraun, S., Young, V., Kenton, D., et al. (1970). Infection from intravenous ’scalp-vein’ needles in a susceptible population. J. Am. Med. Ass. ,212, 451

    Article  Google Scholar 

  44. Peter, G., Lloyd-Still, J. D. and Lovejoy, F. H. (1972). Local infection and bacteremia from scalp vein needles and polyethylene catheters in children. J. Pediatr. ,80, 78

    Article  PubMed  CAS  Google Scholar 

  45. Crossley, K. and Matsen, J. M. (1972). The scalp vein needle: A prospective study of associated complications. J. Am. Med. Ass. ,220, 985

    Article  CAS  Google Scholar 

  46. Crenshaw, C. A., Kelly, L., Turner, R. J. et al. (1972). Prevention of infection at scalp vein sites of needles insertion during intravenous therapy. Am. J. Surg. ,124, 43

    Article  PubMed  CAS  Google Scholar 

  47. Keogh, E. J. and Hopkins, B. E. (1973). Risk of infection with scalp vein needles-prospective study. Aust. N.Z. J. Med. ,3, 389

    Article  PubMed  CAS  Google Scholar 

  48. Harbin, R. L. and Schaffner, W. (1973). Septicemia associated with scalp-vein needles. South. Med. J. ,66, 638

    Article  CAS  Google Scholar 

  49. Maki, D. G., Drinka, P. J. and Davis, T. E. (1975). Suppurative phlebitis of an arm vein from a ’scalp-vein needle’. N. Engl. J. Med. ,292, 1116

    Article  PubMed  CAS  Google Scholar 

  50. Crane, C. (1960). Venous interruption for septic thrombophlebitis. N. Engl. J. Med. ,262, 947

    Article  PubMed  CAS  Google Scholar 

  51. Foley, F. D. (1969). The burn autopsy: fatal complication of burns. Am. J. Clin. Pathol. ,52, 1

    PubMed  CAS  Google Scholar 

  52. Pruitt, B. A., Stein, J. M. and Foley, F. D. (1970). Intravenous therapy in burn patients-uppurative thrombophlebitis and other life-threatening complications. Arch. Surg. ,100, 399

    Article  PubMed  Google Scholar 

  53. Stein, J. M. and Pruitt, B. A. (1970). Suppurative thrombophlebitis-lethal iatrogenic disease. N. Engl. J. Med. ,282, 1452

    Article  PubMed  CAS  Google Scholar 

  54. Barenholtz, L., Kaminsky, N. I. and Palmer, D. L. (1973). Venous intra mural microabscess. A cause of protracted sepsis with intravenous cannulas. Am. J. Med. Sci. ,365, 335

    Article  Google Scholar 

  55. Warden, G. D., Wilmore, D. W. and Pruitt, B. A. (1973). Central venous thrombosis: A hazard of medical progress. J. Trauma ,13, 620

    Article  PubMed  CAS  Google Scholar 

  56. Cormier, M. and Lecompte, Y. (1973). Ligation of veins in suppurative thrombophlebitis secondary to venous catheterization. Surg. Gynecol. Obstet. ,138, 662

    Google Scholar 

  57. Munster, A. M. (1974). Septic thrombophlebitis. A surgical disorder. J. Am. Med. Ass. ,230, 1010

    Article  CAS  Google Scholar 

  58. Popp, M. G., Law, E. J. and MacMillan, B. G. (1974). Parenteral nutrition in the burned child: A study of twenty-six patients. Ann. Surg. ,179, 219

    Article  PubMed  CAS  Google Scholar 

  59. Maki, D. G. and Jarrett, F. (1976). Semi-quantitative culture method for identifying vascular catheter-related septicemia in the burn patient. Surg. Forum (submitted for publication)

    Google Scholar 

  60. Zinner, S. H., Denny-Brown, B. C, Braun, P. et al. (1969). Risk of infection with intravenous indwelling catheters: effect of application of antibiotic ointment. J. Infect. Dis. ,120, 616

    Article  PubMed  CAS  Google Scholar 

  61. Norden, C. W. (1969). Application of antibiotic ointment to the site of venous catheterization-a controlled trial. J. Infect. Dis. ,120, 611

    Article  PubMed  CAS  Google Scholar 

  62. Levy, R. S., Goldstein, J. and Pressman, R. S. (1970). Value of a topical antibiotic ointment in reducing bacterial colonization of percutaneous venous catheters. J. Albert Einstein Med. Ctr. ,18, 67

    Google Scholar 

  63. Crenshaw, C. A., Kelly, L., Turner, R. J. et al. (1972). Bacteriologic nature and prevention of contamination to intravenous catheters. Am. J. Surg. ,123, 264

    Article  PubMed  CAS  Google Scholar 

  64. Irwin, G. R., Hart, R. K. and Martin, C. M. (1973). Pathogenesis and prevention of intravenous catheter infections. Yale J. Biol. Med. ,46, 85

    PubMed  Google Scholar 

  65. Michaelson, E. D. and Walsh, R. E. (1970). Osier’s node-a complication of prolonged arterial cannulation. N. Engl. J. Med. ,283, 472

    Article  PubMed  CAS  Google Scholar 

  66. Gardner, R. M., Schwartz, R., Wong, H. C. and Burke, J. P. (1974). Percutaneous indwelling radial-artery catheters for monitoring cardiovascular function. Prospective study of the risk of thrombosis and infection. N. Engl. J. Med. ,290, 1227

    Article  PubMed  CAS  Google Scholar 

  67. Bedford, R. F. and Wollman, H. (1973). Complications of percutaneous radial-artery cannulation: An objective prospective study in man. Anesthetics ,38, 228

    Article  CAS  Google Scholar 

  68. Todres, I. D., Rogers, M. C., Shannon, D. C., Moylan, F. M. B. and Ryan, J. F. (1975). Percutaneous catheterization of the radial artery in the critically ill neonate. l. Pediatr. ,87, 273

    Article  CAS  Google Scholar 

  69. Maki, D. G. and McCormick, R. (1976). Septic endarteritis due to intraarterial catheters for cancer chemotherapy. I. Clinical features and manage ment. II. Investigation of an outbreak. III. Risk factors and prevention. (Submitted for publication)

    Google Scholar 

  70. Michaels, L. and Ruebner, B. (1953). Growth of bacteria in intravenous infusion fluids. Lancet ,i, 772

    Article  Google Scholar 

  71. Wilmore, D. W. and Dudrick, S. J. (1969). An in-line filter for intravenous solutions. Arch. Surg. ,99, 462

    Article  PubMed  CAS  Google Scholar 

  72. Robertson, M. H. (1970). Fungi in fluids-a hazard of intravenous therapy. J. Med. Microbiol. ,3, 99

    Article  PubMed  CAS  Google Scholar 

  73. Duma, R. J., Warner, J. F. and Dalton, H. P. (1971). Septicemia from intravenous infusions. N. Engl. J. Med. ,284, 257

    Article  PubMed  CAS  Google Scholar 

  74. Maki, D. G., Anderson, R. L. and Shulman, J. A. (1974). In-use contamination of intravenous infusion fluid. Appl. Microbiol. ,28, 778

    PubMed  CAS  Google Scholar 

  75. Maki, D G., Rhame, F. S., Goldmann, D. A. and Mandell, G. L. (1973). The infection hazard posed by contaminated intravenous infusion fluid. Bacteremia-Laboratory and Clinical Aspects. p. 76 (Springfield, Illinois: Charles C. Thomas)

    Google Scholar 

  76. Maki, D. G. and Martin, W. T. (1975). Nationwide epidemic of septicemia caused by contaminated infusion products. IV. Growth of microbial pathogens in fluids for intravenous infusion. J. Infect. Dis. ,131, 267

    Article  PubMed  CAS  Google Scholar 

  77. Deeb, E. N. and Natsios, G. A. (1971). Contamination of intravenous fluids by bacteria and fungi during preparation and administration. Am. J. Hosp. Pharm. ,28, 764

    PubMed  CAS  Google Scholar 

  78. Letcher, K. I., Thrupp, L. D., Schapiro, D. J. et al. (1972). In-use contamination of intravenous solutions in flexible plastic containers. Am, J. Hosp. Pharm. ,29, 673

    CAS  Google Scholar 

  79. Collin, J., Tweedle, D. E. F., Venables, C. W., Constable, F. L. and Johnston, I. D. A. (1973). Effect of a millipore filter on complications of intravenous infusions: A prospective clinical trial. Br. Med. J. ,4, 456

    CAS  Google Scholar 

  80. Ernerot, L., Thoren, S. and Sandeil, E. (1973). Studies on microbial contamination of infusion fluids arising from drug additions and administration. Acta Pharm. Suecica ,10, 141

    CAS  Google Scholar 

  81. Steckel, S. D., Gonik, M., Martens, P. J., Patel, J. A., Curtis, E. G. and Ho, N. F. (1973). Drug Intell. Clin. Pharm., 1, 177

    Google Scholar 

  82. Ravin, R., Bahr, J. et al. (1974). Program for bacterial surveillance of intravenous admixtures. Am. J. Hosp. Pharm. ,31, 340

    PubMed  CAS  Google Scholar 

  83. Woodside, W., Woodside, M. E., D’Arcy, P. F. and Patel, R. H. (1975). Intravenous fluids as vehicles of infection. Pharm. J. ,215, 606

    Google Scholar 

  84. Asch, M. J., Huxtable, R. F. and Hays, D. M. (1972). High calorie parenteral therapy in infants and children. Arch. Surg. ,104, 434

    Article  PubMed  CAS  Google Scholar 

  85. Sanderson, I. and Deitel, M. (1973). Intravenous hyperalimentation without sepsis. Surg. Gynecol. Obstet. ,136, 577

    CAS  Google Scholar 

  86. Miller, R. C. and Grogan, J. B. (1975). Efficacy of in-line bacterial filters in reducing contamination of intravenous nutritional solutions. Am. J. Surg. ,130, 585

    Article  PubMed  CAS  Google Scholar 

  87. Miller, R. C. and Grogan, J. B. (1973). Incidence and source of con tamination of intravenous nutritional infusion systems. J. Pediatr. Surg. ,8, 185

    Article  PubMed  CAS  Google Scholar 

  88. Spatz, M., Ho, N. F., Curtis, M. G. and Pätel, J. A. (1973). The sterility of a screw-capped bottle system containing irrigating solutions. Drug Intel/. Clin. Pharm. ,7, 473

    Google Scholar 

  89. Carney, W. (1971). Management of intravenous infusions. N. Engl. J. Med. ,284, 1037

    Article  Google Scholar 

  90. Mackel, D. C., Maki, D. G., Anderson, R. L., Rhame, F. S. and Bennett, J. V. (1975). Nationwide epidemic of septicemia caused by contaminated intravenous products: mechanisms of intrinsic contamination. J. Clin. Microbioi ,2, 486

    CAS  Google Scholar 

  91. Allwood, M. C. (1975). Microbial contamination of sterile fluids in glass containers. l. Hosp. Pharm. ,33, 119

    Google Scholar 

  92. Garvan, J. M. and Gunner, B. W., (1964). The harmful effects of particles in intravenous fluids. Med. J. Aust. ,2, 1

    PubMed  CAS  Google Scholar 

  93. Miller, W. A., Smith, G. L. and Latiolais, C. J. (1971). A comparative evaluation of compounding costs and contamination rates of intravenous admixture systems. Drug Intell. Clin. Pharm. ,5, 51

    Google Scholar 

  94. Poretz, D. M., Guynn, J. B., Duma, R. J. and Dalton, H. P. (1974). Microbial contamination of glass bottle (open-vented) and plastic bag (closed-nonvented) intravenous fluid delivery systems. Am. J. Hosp. Pharm. ,31, 726

    PubMed  CAS  Google Scholar 

  95. McAllister, J. C., Buchanan, E. C. and Skolaut, M. W. (1974). A comparison of the safety and efficiency of three intermittent intravenous therapy systems-the minibottle, the minibag and the in-line burette. Am. J. Hosp. Pharm. ,31, 961

    PubMed  CAS  Google Scholar 

  96. Perceval, A. K. (1966). Contamination of parenteral solutions during administration. Med. J. Aust. ,2, 954

    PubMed  CAS  Google Scholar 

  97. Arnold, T. R. and Hepler, C. D. (1971). Bacterial contamination of intravenous fluids opened in unsterile air. Am. J. Hosp. Pharm. ,28, 614

    PubMed  CAS  Google Scholar 

  98. Hansen, J. S. and Hepler, C. D. (1973). Contamination of intravenous solutions by airborne microbes. Am. J. Hosp. Pharm. ,30, 326

    PubMed  CAS  Google Scholar 

  99. Greene, V. W., Vesley, D. ,Bond, R. G. and Michaelsen, G. S. (1962). Microbiological contamination of hospital air. II. Qualitative studies.

    Google Scholar 

  100. Buth, J. A., Coverly, R. W. and Eckel, F. M. (1973). A practical method of sterility monitoring of IV admixtures and a method of implementing a routine sterility monitoring program. Drug Intell. Clin. Pharm. ,7, 276

    Google Scholar 

  101. Kundsin, R. B., Walter, C. W. and Scott, J. A. (1973). In-use testing of sterility of intravenous solutions in plastic containers. Surgery ,73, 778

    PubMed  CAS  Google Scholar 

  102. Hanson, A. L. and Shelley, R. M. (1974). Monitoring contamination levels of intravenous solutions using ’total-sample’ techniques. Am. J. Hosp. Pharm. ,31, 733

    PubMed  CAS  Google Scholar 

  103. Hak, L. J., Long, J. M., Ruberg, R. L. et al. (1971). Contamination incidence in IV solutions with additives. Presented to the Annual Meeting of the American Society of Hospital Pharmacists, 31 March 1971

    Google Scholar 

  104. Ryan, J. A., Abel, R. M., Abbott, W. M. et al. (1974). Catheter complica tions in total parenteral nutrition: A prospective study of 200 consecutive patients. N. Engl. J. Med. ,290, 757

    Article  PubMed  Google Scholar 

  105. Copeland, E. M., MacFadyen, B. V. and Dudrick, S. J. (1974). Prevention of microbial catheter contamination in patients receiving parenteral hyperalimentation. South. Med. J. ,67, 303

    Article  PubMed  Google Scholar 

  106. Herman, L. G. (1970). A critical evaluation of microbiological hazards associated with the pharmacy and the hospital. Am. J. Hosp. Pharm. ,27, 56

    PubMed  CAS  Google Scholar 

  107. D’Arcy, P. F. and Woodside, W. (1973). Drug additives: A potential source of bacterial contamination of infusion fluids. Lancet ,ii, 96

    Article  Google Scholar 

  108. McArthur, B. J., Hargiss, C. and Schoenknecht, F. D. (1975). Stopcock contamination in an ICU. Am. J. Nursing ,75, 96

    CAS  Google Scholar 

  109. James, J. D. (1959). Bacterial contamination of reserved blood. Vox Sang. ,4, 177

    Article  PubMed  CAS  Google Scholar 

  110. Buchholz, D. H., Young, V. M., Friedman, N. R. et al. (1971). Bacterial proliferation in platelet products stored at room temperature. N. Engl. J. Med. ,285, 429

    Article  PubMed  CAS  Google Scholar 

  111. Stevens, A. R., Legg, J. S., Henry, B. S. et al. (1953). Fatal transfusion reactions from contamination of stored blood by cold growing bacteria. Ann. Intern. Med. ,39, 1228

    PubMed  Google Scholar 

  112. Braude, A. I. (1958). Transfusion reactions from contaminated blood. Their recognition and treatment. N. Engl. J. Med. ,258, 1289

    Article  PubMed  CAS  Google Scholar 

  113. Rhame, F. S., Root, F. K., MacLowry, T. A. et al. (1973). Salmonella septicemia from platelet transfusions. Ann. Intern. Med. ,78, 633

    PubMed  CAS  Google Scholar 

  114. Freeman, J. B., Lemire, A. and MacLean, L, D. (1972). Intravenous alimentation and septicemia. Surg. Gynecol. Obstet. ,135, 708

    PubMed  CAS  Google Scholar 

  115. Boeckman, C. R. and Krill, C. E. Jr. (1970). Bacterial and fungal infections complicating parenteral alimentation in infants and children. J. Pediatr. Surg. ,5, 117

    Article  PubMed  CAS  Google Scholar 

  116. Weyrauch, H. M. and Bassett, J. B. (1951). Ascending infection in an artificial urinary tract; an experimental study. Stanford Med. Bull. ,9, 25

    PubMed  CAS  Google Scholar 

  117. Ashcraft, K. W. and Leape, L. L. (1970). Candida sepsis complicating parenteral feeding. J. Am. Med. Ass. ,212, 454

    Article  CAS  Google Scholar 

  118. US National Coordinating Committee on Large Volume Parenterals. (1975). Recommended system for surveillance and reporting of problems with large-volume parenterals in hospitals. Am. J. Hosp. Pharm. ,32, 1251

    Google Scholar 

  119. Rusmin, S., Althauser, M. B. and DeLuca, P. P. (1975). Consequence of microbial contamination during extended intravenous therapy using in-line filters. Am. J. Hosp. Pharm. ,32, 373

    PubMed  CAS  Google Scholar 

  120. Maki, D. G. (1976). Final Filters. Hosp. Inf. Control ,3, 22

    Google Scholar 

  121. Feeman, J. B. and Litton, A. A. (1974). Preponderance of Gram-positive infections during parenteral alimentation. Surg. Gynecol. Obstet. ,139, 905

    Google Scholar 

  122. Dillon, J. D., Schaffner, W., Van Way, C. W. and Meng, H. C. (1973). Septicemia and total parenteral nutrition. Distinguishing catheter-related from other septic episodes. J. Am. Med. Ass. ,223, 1341

    Article  Google Scholar 

  123. Copeland, E. M., MacFadyen, B. V., McGown, C. and Dudrick, S. J. (1974). The use of hyperalimentation in patients with potential sepsis. Surg. Gynecol. Obstet. ,138, 377

    PubMed  Google Scholar 

  124. Turco, S. and Davis, N. M. (1973). Clinical significance of particulate matter; a review of the literature. Hosp. Pharm. ,8, 137

    Google Scholar 

  125. Ryan, P. B., Rapp, R. P., DeLuca, P. O. et al. (1973). In-line final filtration -a method of minimizing the risk of bacterial, fungal, and particle contamination in intravenous therapy. Bull. Parenter. Drug Ass. ,27, 1

    CAS  Google Scholar 

  126. DeLuca, P. O., Rapp, R. P., Bivins, B., McKean, H. E. and Griffen, W. O. (1975). Filtration and infusion phlebitis: a double-blind prospective study. Am. J. Hosp. Pharm. ,32, 1001

    PubMed  CAS  Google Scholar 

  127. Dudrick, S. J., Wilmore, D. W., Vars, H. M. et al. (1968). Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery ,64, 134

    PubMed  CAS  Google Scholar 

  128. Goldmann, D. A. and Maki, D. G. (1973). Infection control in total parenteral nutrition. J. Am. Med. Ass. ,223, 1360

    Article  CAS  Google Scholar 

  129. Curry, C. R. and Quie, P. G. (1971). Fungal septicemia in patients receiving parenteral hyperalimentation. N. Engl. J. Med. ,285, 1221

    Article  PubMed  CAS  Google Scholar 

  130. Goldmann, D. A., Martin, W. T. and Worthington, J. W. (1973). Growth of bacteria and fungi in total parenteral nutrition solutions. Am. J. Surg. ,126, 314

    Article  PubMed  CAS  Google Scholar 

  131. Wilmore, D. W. and Dudrick, S. J. (1969). Safe long-term venous catheterization. Arch. Surg. ,98, 256

    Article  PubMed  CAS  Google Scholar 

  132. Abel, R. M., Fischer, J. E., Buckley, M. J. and Austen, W. G. (1974). Hyperalimentation in cardiac surgery; a review of sixty-four patients. Surg. Gynecol. Obstet. ,139, 468

    Google Scholar 

  133. Bentley, D. E. and Lepper, M. H. (1968). Septicemia related to indwelling venous catheter. J. Am. Med. Ass. ,206, 1749

    Article  CAS  Google Scholar 

  134. Corso, J. A., Agostinelli, R. and Brandriss, M. W. (1969). Maintenance of venous polyethylene catheters to reduce risk of infection. J. Am. Med. Ass. ,210, 2075

    Article  CAS  Google Scholar 

  135. Fuchs, P. C. (1971). Indwelling intravenous polyethylene catheters. Factors influencing the risk of microbial colonization and sepsis. J. Am. Med. Ass. ,216, 1447

    Article  CAS  Google Scholar 

  136. Freeman, R. and King, B. (1975). Recognition of infection associated with intravenous catheters. Br. J. Surg. ,62, 404

    Article  PubMed  CAS  Google Scholar 

  137. Maki, D. G. and Agger, W. (1976). The profile of vascular catheter-related septicemia in an intensive care unit population. (In preparation for publi cation)

    Google Scholar 

  138. Maki, D. G. (1976). Preventing infection in intravenous therapy. Hosp. Pract. ,11, 95

    PubMed  CAS  Google Scholar 

  139. Bennett, J. V., Scheckler, W. E., Maki, D. G. et al. (1971). Current National Patterns, United States. Proceedings of the International Conference on Nosocomial Infections. (Chicago: American Hospital Association)

    Google Scholar 

  140. Goldmann, D. A., Fulkerson, C. C., Dixon, R. E., Maki, D. G. and Bennett, J. V. (1976). Nationwide epidemic of septicemias caused by contaminated intravenous products. II. Assessment of the problem by a National Nosocomial Infection Surveillance System. (Submitted for publication)

    Google Scholar 

  141. ClufT, L. E. (1970). Surveillance as a control system-Panel. Statement of Moderator. Proceedings of the International Conference on Nosocomial Infections. (Chicago: American Hospital Association)

    Google Scholar 

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Authors
  1. D. G. Maki
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Editors and Affiliations

  1. Department of Microbiology, St Thomas’s Hospital Medical School, London, SE1 7EH, UK

    I. Phillips

  2. Public Health Laboratory, Greenbank Hospital, PL4 8NN, Plymouth, Devon, UK

    P. D. Meers

  3. The Queen’s University of Belfast, Lisburn Road, Belfast, BT9 7BL, Northern Ireland

    P. F. D’Arcy

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© 1976 MTP Press Ltd

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Maki, D.G. (1976). Sepsis arising from extrinsic contamination of the infusion and measures for control. In: Phillips, I., Meers, P.D., D’Arcy, P.F. (eds) Microbiological Hazards of Infusion Therapy. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-6179-4_7

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  • DOI: https://doi.org/10.1007/978-94-011-6179-4_7

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-6181-7

  • Online ISBN: 978-94-011-6179-4

  • eBook Packages: Springer Book Archive

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