Pseudomonas cepacia bacteraemia due to intrinsic contamination of an anaesthetic. Bacteriological and serological observations. 1979

J G Borghans, and M T Hosli, and H Olsen, and E M Ravn, and K Siboni, and P Søgaard

In November-December 1977 an epidemic of bacteraemia due to P. cepacia was observed in Odense, Denmark (nine patients), and in Nijmegen, Holland (seven patients). All patients recovered. The epidemic was traced to intrinsic contamination of two batches of the anaesthetic fentanyl. All isolates from the patients and from the two batches belonged to the same biotype, had identical sensitivity patterns, and identical antigens. The P. cepacia strain differed from stock strains in being able to grow in two passages in methyl-p-hydroxi-benzoate, 0.5 mg/ml, which promoted the growth of the microorganism: inocula of 2-20 cfu were sufficient to initiate growth in the drug or preservative. These facts indicate the inadvisability of using p-hydroxi-benzoates as preservatives in vials. The strain was inhibited at temperatures above 38.5 degrees C, corresponding to the recovery of the patients after a period with fever above 39 degrees C. Fourteen out of 15 patients examined had agglutinin titres greater than or equal to 320, while 36 blood donors had titres less than 40. Of 12 patients with postoperative fever in the same period whose blood cultures did not yield P. cepacia, three had titres greater than 320.

UI MeSH Term Description Entries
D010592 Pharmaceutic Aids Substances which are of little or no therapeutic value, but are necessary in the manufacture, compounding, storage, etc., of pharmaceutical preparations or drug dosage forms. They include SOLVENTS, diluting agents, and suspending agents, and emulsifying agents. Also, ANTIOXIDANTS; PRESERVATIVES, PHARMACEUTICAL; COLORING AGENTS; FLAVORING AGENTS; VEHICLES; EXCIPIENTS; OINTMENT BASES. Aids, Pharmaceutic,Aids, Pharmaceutical,Pharmaceutical Aids
D011310 Preservatives, Pharmaceutical Substances added to pharmaceutical preparations to protect them from chemical change or microbial action. They include ANTI-BACTERIAL AGENTS and antioxidants. Pharmaceutic Aids (Preservatives),Pharmaceutic Preservative,Pharmaceutic Preservatives,Pharmaceutical Preservative,Pharmaceutical Preservatives,Preservative, Pharmaceutic,Preservative, Pharmaceutical,Preservatives, Pharmaceutic
D011552 Pseudomonas Infections Infections with bacteria of the genus PSEUDOMONAS. Infections, Pseudomonas,Pseudomonas aeruginosa Infection,Infection, Pseudomonas,Pseudomonas Infection,Pseudomonas aeruginosa Infections
D003718 Denmark A country in northern Europe, bordering the Baltic Sea and the North Sea. The capital is Copenhagen. Faeroe Islands,Faroe Islands
D004340 Drug Contamination The presence of organisms, or any foreign material that makes a drug preparation impure. Drug Adulteration,Drug Contamination, Chemical,Drug Contamination, Microbial,Drug Contamination, Physical,Drug Impurity,Adulteration, Drug,Chemical Drug Contamination,Chemical Drug Contaminations,Contamination, Chemical Drug,Contamination, Drug,Contamination, Microbial Drug,Contamination, Physical Drug,Contaminations, Chemical Drug,Contaminations, Microbial Drug,Contaminations, Physical Drug,Drug Adulterations,Drug Contaminations,Drug Contaminations, Chemical,Drug Contaminations, Microbial,Drug Contaminations, Physical,Drug Impurities,Impurity, Drug,Microbial Drug Contamination,Microbial Drug Contaminations,Physical Drug Contamination,Physical Drug Contaminations
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000777 Anesthetics Agents capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. Anesthetic,Anesthetic Agents,Anesthetic Drugs,Anesthetic Effect,Anesthetic Effects,Agents, Anesthetic,Drugs, Anesthetic,Effect, Anesthetic,Effects, Anesthetic
D000907 Antibodies, Bacterial Immunoglobulins produced in a response to BACTERIAL ANTIGENS. Bacterial Antibodies
D000942 Antigens, Bacterial Substances elaborated by bacteria that have antigenic activity. Bacterial Antigen,Bacterial Antigens,Antigen, Bacterial

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