Maki D G, Anderson R L, Shulman J A
Appl Microbiol. 1974 Nov;28(5):778-84. doi: 10.1128/am.28.5.778-784.1974.
During the 1970 to 1971 nationwide epidemic of septicemias caused by Enterobacter cloacae and Enterobacter agglomerans traced to intrinsic contamination of Abbott intravenous infusion products, 94 infusion systems manufactured by Baxter Laboratories were studied microbiologically and epidemiologically during hospital use. Intravenous fluid from 10 systems (11%) contained microorganisms, usually Staphylococcus or Bacillus species; one infusion was heavily contaminated with Klebsiella pneumoniae. No national epidemic organisms, E. cloacae or E. agglomerans (formerly Erwinia), were recovered, suggesting that during this period frequent contamination with these organisms was unique to Abbott's infusion products. Contamination in this study appeared to be extrinsic in origin (introduced during clinical use) and related to the duration of continuous intravenous therapy. Nine of 61 systems (15%) that had been used longer than 48 h were contaminated, whereas only 1 of 33 used less than 48 h (3%) contained microorganisms. This study and the recent national outbreak indicate that contamination of infusion fluid, both from intrinsic and extrinsic sources, must be recognized as an additional risk of intravenous therapy; however, a once-daily replacement of the delivery apparatus can significantly diminish this hazard.
在1970年至1971年全国范围内由阴沟肠杆菌和聚团肠杆菌引起的败血症流行期间，此次流行追溯至雅培静脉输液产品的内在污染，对百特实验室生产的94个输液系统在医院使用期间进行了微生物学和流行病学研究。10个系统（11%）的静脉输液含有微生物，通常为葡萄球菌或芽孢杆菌属；一次输液被肺炎克雷伯菌严重污染。未检出全国流行的病原体阴沟肠杆菌或聚团肠杆菌（以前为欧文氏菌），这表明在此期间这些病原体的频繁污染是雅培输液产品所特有的。本研究中的污染似乎源于外部（在临床使用期间引入），并与持续静脉治疗的持续时间有关。61个使用时间超过48小时的系统中有9个（15%）被污染，而33个使用时间少于48小时的系统中只有1个（3%）含有微生物。本研究和近期的全国性疫情表明，来自内在和外部来源的输液污染都必须被视为静脉治疗的额外风险；然而，每天更换一次输液装置可显著降低这种风险。
