Nakashima A K, McCarthy M A, Martone W J, Anderson R L
J Clin Microbiol. 1987 Jun;25(6):1014-8. doi: 10.1128/jcm.25.6.1014-1018.1987.
During a 6-week period, 10 patients were admitted to a hospital for treatment of knee or shoulder joint infections due to Serratia species. Isolates from eight patients were identified as Serratia marcescens with identical biochemical characteristics and antibiotic susceptibility patterns. Before the onset of infections, all patients had been treated by two orthopedic surgeons who shared an office. Studies revealed that infections were associated with previous joint injections (P = 4.44 X 10(-5] of methylprednisolone and lidocaine. Environmental cultures revealed that a canister of cotton balls soaked in aqueous benzalkonium chloride and two multiple-dose vials of methylprednisolone previously used by office personnel were contaminated with the epidemic strain of S. marcescens. The canister may have served as a potential reservoir for contamination of sterile solutions and equipment used for joint injections, of skin at the injection site, and of hands of personnel. No further cases occurred after the use of aqueous benzalkonium chloride was discontinued.
在为期6周的时间里，有10名患者因沙雷氏菌属感染膝关节或肩关节而入院治疗。从8名患者身上分离出的菌株被鉴定为具有相同生化特征和抗生素敏感性模式的粘质沙雷氏菌。在感染发生前，所有患者均由在同一办公室工作的两名骨科医生进行过治疗。研究表明，感染与之前注射甲基泼尼松龙和利多卡因的关节注射有关（P = 4.44×10⁻⁵）。环境培养显示，办公室人员之前使用的一罐浸泡在苯扎氯铵水溶液中的棉球以及两小瓶多剂量甲基泼尼松龙被粘质沙雷氏菌的流行菌株污染。该罐子可能成为用于关节注射的无菌溶液和设备、注射部位皮肤以及工作人员手部污染的潜在源头。停用苯扎氯铵水溶液后未再出现新的病例。
