Table 2 Outbreaks related to bacterial and fungal contamination of infusates in healthcare facilities in low- and middle-income countries: products involved, and pathogens isolated
Author, year, country (n = 50) | Type and use of the infusate involved | Pathogens isolated (n = 56) |
|---|---|---|
Thong 1975 [2] Malaysia (lower-MIC) | 5% dextrose-saline used in pediatrics | Burkholderia cepacia |
Koopman 1980 [3] Colombia (lower-MIC) | Saline-dextrose-potassium admixture used in pediatrics | Klebsiella pneumoniae |
Lacey 1991 [4] South Africa (lower-MIC) | Intrinsically contaminated sterile distilled water used to reconstitute heparin for flushing central venous catheters in pediatrics | Ralstonia pickettii |
Frean 1994* [5] South Africa (lower-MIC) | Intrinsically contaminated TPN used in pediatrics | Serratia odorifera |
Worku 1997* [6] Ethiopia (LIC) | Saline-dextrose admixture used in pediatrics | Klebsiella oxytoca |
Kapil 1998* [7] India (Lower-MIC) | mSDV of saline-heparin admixture used to flush intravascular catheters used in adults | Acinetobacter baumannii |
Mathews 1998 [8] India (lower-MIC) | Case report of a neonate who received an IV fluid | Saprochaete capitata |
Thuler 1998* [9] Brazil (upper-MIC) | Intrinsically contaminated IV calcium gluconate used in adults | Bacillus circulans |
Van Nierop 1998 [11] South Africa (upper-MIC) | mSDV of IV amino acid premixture used in neonates | Enterobacter cloacae |
Lalitha 1999 [11] India (lower-MIC) | Intrinsically contaminated dextrose used in neonates | Klebsiella pneumoniae |
Tresoldi 2000* [12] Brazil (upper-MIC) | TPN used in neonates | Enterobacter cloacae |
Ganeswire 2003 [13] Malaysia (lower-MIC) | mSDV of dextrose used to reconstitute antibiotics in neonates | Pluralibacter gergoviae |
Güngör 2003* [14] Türkiye (upper-MIC) | mSDV of IV lipid premixture added to TPN solution, used in neonates | Elizabethkingia meningoseptica |
Habsah 2005* [15] Malaysia (lower-MIC) | TPN used in neonates | Pantoea sp. |
Moodley 2005 [16] South Africa (upper-MIC) | mSDV of dextrose-amino acid premixture used in neonates | Klebsiella pneumoniae |
Moore 2005 [17] Egypt (lower-MIC) | mSDV of dextrose, MDV of a steroid and mSDV of an immunoglobulin solution used in neonates | Klebsiella pneumoniae |
Moreira 2005* [18] Brazil (upper-MIC) | Intrinsically contaminated Water for Injection used in adults and neonates | Burkholderia cepacia Ralstonia pickettii |
Marais 2006 [19] South Africa (upper-MIC) | TPN used in neonates | Klebsiella pneumoniae |
Vegas 2006 [20] Venezuela (upper-MIC) | TPN used in neonates | Acinetobacter sp. |
Campos 2007 [21] Brazil (upper-MIC) | Intrinsically contaminated TPN used in neonates | Enterobacter hormaechei |
Dias 2008 [22] Brazil (upper-MIC) | Intrinsically contaminated heparin used in adults and pediatrics | Pseudomonas putida |
Douce 2008 [23] Ecuador (lower-MIC) | Intrinsically contaminated Water for Injection used to dilute antibiotics | Burkholderia cepacia Myroides odoratus |
Narayan 2009 [24] Fiji (lower-MIC) | mSDV of saline used to flush intravascular catheters and dilute antibiotics used in neonates | Klebsiella aerogenes |
Arslan 2010 [25] Türkiye (upper-MIC) | TPN used in neonates | Serratia marcescens |
Martins 2010 [26] Brazil (upper-MIC) | Intrinsically contaminated IV bromopride medication used in adults | Burkholderia cepacia |
Liu 2011 [27] China (lower-MIC) | mSDV of heparinized saline used to flush intravascular catheters in adults | Serratia marcescens |
DeSmet 2013 [28] Cambodia (lower-MIC) | mSDV of Ringer’s lactate used to flush intravascular catheters in adults | Burkholderia cepacia |
Liu 2014 [29] China (lower-MIC) | Dextrose-saline-isosorbide dinitrate-potassium aspartate admixture used in adults | Pseudomonas fulva |
Singhal 2015 [30] India (lower-MIC) | Intrinsically contaminated IV granisetron medicine vials used in adults | Burkholderia cepacia |
Guducuoglu 2016 [31] Türkiye (upper-MIC) | TPN used in pediatrics | Candida albicans |
Ikumapayi 2016 [32] The Gambia (LIC) | mSDV of saline used in pediatrics | Serratia liquefaciens |
Jain 2016 [33] India (lower-MIC) | mSDV of dextrose used to flush intravascular catheters used in neonates | Proteus mirabilis |
Paul 2016 [34] India (lower-MIC) | mSDV of saline and dextrose used in neonates | Burkholderia cepacia |
Shrivastava 2016 [35] India (lower-MIC) | Intrinsically contaminated IV caffeine citrate medicine vials used in neonates | Burkholderia cepacia |
Ari 2017 [36] Türkiye (upper-MIC) | mSDV of saline used to dilute contrast agent used in myocardial scintigraphy in adults | Serratia liquefaciens |
Orsini 2018 [37] Chile (upper-MIC) | Intrinsically contaminated ondansetron used in adults and pediatrics | Sarocladium kiliense |
Pillonetto 2018 [38] Brazil (upper-MIC) | Intrinsically contaminated TPN | Acinetobacter baumannii Phytobacter diazotrophicus |
Intrinsically contaminated calcium gluconate | Rhizobium radiobacter | |
Cilli 2019 [39] Türkiye (upper-MIC) | mSDV of IV propofol used in adults | Serratia marcescens |
Eshetu 2019 [40] Ethiopia (LIC) | mSDV of IV fluid used in a neonate | Klebsiella oxytoca |
Okomo 2020 [41] The Gambia (LIC) | mSDV of saline and dextrose used to reconstitute antibiotics mSDV of gentamicin and metronidazole used in neonates | Burkholderia cepacia |
Klebsiella pneumoniae | ||
Arjun 2021 [42] Türkiye (upper-MIC) | Intrinsically contaminated IV furosemide medicine ampoules used in adults | Achromobacter denitrificans Achromobacter xylosoxidans |
Garza-Gonzalez 2021 [43] Mexico (upper-MIC) | Intrinsically contaminated TPN used in neonates | Leclercia decarboxylata |
Jaber 2021 [44] Morocco (lower-MIC) | mSDV of propofol used in adults | Klebsiella oxytoca |
Murugesan 2021 [45] India (lower-MIC) | Intrinsically contaminated IV diltiazem medicine used in adults | Burkholderia contaminans |
Tunccan 2021 [46] Türkiye (upper-MIC) | Intrinsically contaminated IV saline bottles used in pediatrics and adults | Ralstonia solanacearum |
Ergenc 2022 [47] Türkiye (upper MIC) | mSDV of propofol used in adults | Serratia marcescens |
Moukafih 2022 [48] Morocco (lower-MIC) | mSDV of propofol used in pediatrics | Enterobacter cloacae |
Rajachandaran 2022 [49] India (lower-MIC) | Intrinsically contaminated IV fentanyl medicine vials used in adults | Ralstonia pickettii |
Sridharan 2022 [50] India (lower-MIC) | Intrinsically contaminated diltiazem vials used in adults | Burkholderia cepacia |
Fomda 2023 [51] India (lower-MIC) | mSDV saline used to flush intravascular catheters used in adults | Burkholderia cepacia |