Keys T F, Melton L J, Maker M D, Ilstrup D M
J Infect Dis. 1983 Mar;147(3):489-93. doi: 10.1093/infdis/147.3.489.
Pseudomonas stutzeri was recovered from blood cultures of 24 patients from 1977 through 1979 at one Mayo Clinic-affiliated hospital. During the investigation it was determined that aqueous green soap--used throughout the hospital to prepare the skin for iv insertions--had probably become contaminated with P. stutzeri. The use of aqueous green soap was discontinued, but eight additional cases of pseudobacteremia occurred in 1980-1981 and one case occurred in 1982. With one exception, all of the patients appeared to have pseudobacteremia rather than true bacteremia; the outbreak ceased only after aqueous green soap was deleted as a standard stock item from the hospital formulary.
1977年至1979年期间,在梅奥诊所附属的一家医院,从24名患者的血培养物中分离出斯氏假单胞菌。调查发现,该医院一直用于静脉穿刺前皮肤准备的水性绿皂可能已被斯氏假单胞菌污染。水性绿皂的使用被停止,但在1980年至1981年又出现了8例伪菌血症病例,1982年出现了1例。除1例例外,所有患者似乎患的都是伪菌血症而非真正的菌血症;只有在水性绿皂从医院处方中作为标准库存物品被删除后,疫情才停止。