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

Published online by Cambridge University Press:  02 January 2015

Alejandro E. Macías ,
Juan M. Muñoz ,
Laura E. Herrera ,
Humberto Medina ,
Isabel Hernández ,
Dolores Alcántar  and
Samuel Ponce de León
Alejandro E. Macías*
Affiliation:
University of Guanajuato School of Medicine at Leon, Leon, Mexico
Juan M. Muñoz
Affiliation:
University of Guanajuato School of Medicine at Leon, Leon, Mexico
Laura E. Herrera
Affiliation:
University of Guanajuato School of Medicine at Leon, Leon, Mexico
Humberto Medina
Affiliation:
University of Guanajuato School of Medicine at Leon, Leon, Mexico
Isabel Hernández
Affiliation:
University of Guanajuato School of Medicine at Leon, Leon, Mexico
Dolores Alcántar
Affiliation:
National Autonomous University of Mexico, Experimental Medicine Department, Mexico City, Mexico
Samuel Ponce de León
Affiliation:
National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
*
Facultad de Medicina de León, 20 de Enero 929, León Guanajuato 37320, México
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Abstract

Objective:

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

Design:

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

Setting:

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

Patients:

Hospitalized pediatric patients receiving intravenous solutions.

Results:

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%).

Conclusion:

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

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 3 , March 2004 , pp. 226 - 230
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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