Sepsis Caused by Contaminated Intravenous Fluids

Abstract

Thirty-one cases of nosocomial sepsis that occurred from July 1970 through May 1971 in a 500-bed hospital were related to bacterial contamination of intravenous fluid bottles produced by one manufacturer. The responsible microorganisms were Erwinia, Enterobacter cloacae, and Pseudomonas stutzeri. These uncommon bloodstream pathogens caused a persistent Gram-negative sepsis that was refractory to antimicrobial therapy. Discontinuation of intravenous therapy and replacement of the intravenous administration system were the only effective treatments. The organisms multiplied to concentrations of from 105 to 106 bacteria per millilitre in intravenous fluids, although the concentrations were never high enough to cause visible turbidity. Laboratory studies of these epidemic strains showed no significant differences from a control Escherichia coli in serum sensitivity, ease of phagocytosis, endotoxin production, or mouse virulence.