Maki D G, Martin W T
J Infect Dis. 1975 Mar;131(3):267-72. doi: 10.1093/infdis/131.3.267.
Septicemia caused by contaminated infusion fluid is a newly appreciated hazard of intravenous infusion therapy. Microorganisms of the tribe Klebsielleae (Klebsiella, Enterobacter, and Serratia) have predominated in these infections. Members of this tribe found to possess a selecive ability over common non-Klebsielleae microbial pathogens to proliferate rapidly in commerical parential fluids contaning clucose at room temperautre. Fifty-one Klebsielleae strains, washed twice before inoculation of approximately 1 organism/ml, attained a mean normalized 24 hr concentration of 1.11 x 10-5 organisms/ml in 5% dextrose in water at 25 C. In contrast, 48 of 49 non-Klebsielleae bacterial strains (clinical isolates of Staphylococcus, Proteus, Escherichia coli, Herelea, and Pseudomonas aeruginosa) slowly died (mean 24-hr concentration, 0.2 organism/ml). Five Candida albicans strains frew only very slowly (31.3 organisms/ml). Even with concentrations exceeding 10-6 organisms/ml, microbial presence was never visibly detectable. The significant increases in cases of nosocomial spticmia caused by Klebsiella, Enterobacter, and Serratia in recent years might be attribuatble in part to fluid-related spesis accompanying the expanding use of parenteral therapy.
受污染的输液引起的败血症是静脉输液治疗新发现的一种危害。克雷伯菌族（克雷伯菌属、肠杆菌属和沙雷菌属）的微生物在这些感染中占主导地位。已发现该菌族成员比常见的非克雷伯菌族微生物病原体具有更强的在室温下含葡萄糖的商业静脉输液中快速增殖的能力。51株克雷伯菌菌株在接种前洗涤两次，接种量约为每毫升1个菌，在25℃的5%葡萄糖水溶液中24小时后平均标准化浓度达到1.11×10⁻⁵个菌/毫升。相比之下，49株非克雷伯菌族细菌菌株（金黄色葡萄球菌、变形杆菌、大肠杆菌、赫雷菌属和铜绿假单胞菌的临床分离株）中有48株缓慢死亡（24小时平均浓度为每毫升0.2个菌）。5株白色念珠菌菌株生长极为缓慢（每毫升31.3个菌）。即使浓度超过每毫升10⁻⁶个菌，微生物也从未肉眼可见。近年来由克雷伯菌属、肠杆菌属和沙雷菌属引起的医院内败血症病例显著增加，部分原因可能是随着肠外治疗的广泛使用而出现的与输液相关的败血症。
