Pseudomonas Cepacia Bacteræmia Due to Intrinsic Contamination of an Anæsthetic

Abstract

In Nov.-Dec. 1977 an epidemic of bacteremia due to P. cepacia was observed in Odense, Denmark (9 patients), and in Nijmegen, Holland (7 patients). All patients recovered. The epidemic was traced to intrinsic contamination of 2 batches of the anesthetic fentanyl. All isolates from the patients and from the 2 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 2 passages in methyl-p-hydroxybenzoate, 0.5 mg/ml, which promoted the growth of the microorganism; inocula of 2-20 cfu [colony forming units] were sufficient to initiate growth in the drug or preservative. The inadvisability of using p-hydroxybenzoates as preservatives in vials was indicated. The strain was inhibited at temperatures above 38.5.degree. C, corresponding to the recovery of the patients after a period with fever above 39.degree. C. Of 15 patients examined, 14 had agglutinin titers .gtoreq. 320, while 36 blood donors had titers < 40. Of 12 patients with postoperative fever in the same period whose blood cultures did not yield P. cepacia, 3 had titers > 320.