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Nosocomial Pediatric Bacteremia: The Role of Intravenous Set Contamination in Developing Countries

  • Alejandro E. Macías (a1), Juan M. Muñoz (a1), Laura E. Herrera (a1), Humberto Medina (a1), Isabel Hernández (a1), Dolores Alcántar (a2) and Samuel Ponce de León (a3)...



To assess the rate of bacterial contamination of intravenous administration sets at their rubber injection ports and matching infusates.


Cultures of injection ports and infusate during 26 visits to 4 hospitals.


Four public general pediatric hospitals in Mexico City with substandard care practices.


Hospitalized pediatric patients receiving intravenous solutions.


Overall, 176 of 251 injection ports were contaminated (70.1%; 95% confidence interval [CI95], 64.5% to 75.8%), 35 (13.9%; CI95, 9.7% to 18.2%) with gram-negative rods, primarily of the tribe Klebsielleae. Cultures of infusates were positive in 17 cases (6.8%, CI95, 3.7% to 9.9%), 5 of which grew gram-negative rods (2%; CI95, 0.6% to 4.6%). In 3 cases (1.2%), the same species with gram-negative rods was found in the infusates and on the injection ports. During one visit, 8 clustered cases of injection port contamination with a clonal Enterobacter cloacae were found; this agent was also found in the blood culture, intravenous fluid, and parenteral nutrition of one patient. Inadequate chlorination of tap water, a potential risk factor, was recorded during 22 visits (84.6%).


These data suggest that external contamination of the intravenous administration set could play a role in infusate contamination.


Corresponding author

Facultad de Medicina de León, 20 de Enero 929, León Guanajuato 37320, México


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