Sphingomonas paucimobilis bloodstream infections associated with contaminated intravenous fentanyl

Lisa Maragakis, Romanee Chaiwarith, Arjun Srinivasan, Francesca J. Torriani, Edina Avdic, Andrew Lee, Tracy R. Ross, Karen C Carroll, Trish M. Perl

Research output: Contribution to journalArticle

Abstract

Nationally distributed medications from compounding pharmacies, which typically adhere to less stringent quality-control standards than pharmaceutical manufacturers, can lead to multistate outbreaks. We investigated a cluster of 6 patients in a Maryland hospital who had Sphingomonas paucimobilis bloodstream infections in November 2007. Of the 6 case-patients, 5 (83%) had received intravenous fentanyl within 48 hours before bacteremia developed. Cultures of unopened samples of fentanyl grew S. paucimobilis; the pulsed-field gel electrophoresis pattern was indistinguishable from that of the isolates of 5 case-patients. The contaminated fentanyl lot had been prepared at a compounding pharmacy and distributed to 4 states. Subsequently, in California, S. paucimobilis bacteremia was diagnosed for 2 patients who had received intravenous fentanyl from the same compounding pharmacy. These pharmacies should adopt more stringent quality-control measures, including prerelease product testing, when compounding and distributing large quantities of sterile preparations.

Original languageEnglish (US)
Pages (from-to)12-18
Number of pages7
JournalEmerging Infectious Diseases
Volume15
Issue number1
DOIs
StatePublished - Jan 2009

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Sphingomonas
Fentanyl
Pharmacies
Bacteremia
Infection
Quality Control
Pulsed Field Gel Electrophoresis
Disease Outbreaks
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Epidemiology

Cite this

Sphingomonas paucimobilis bloodstream infections associated with contaminated intravenous fentanyl. / Maragakis, Lisa; Chaiwarith, Romanee; Srinivasan, Arjun; Torriani, Francesca J.; Avdic, Edina; Lee, Andrew; Ross, Tracy R.; Carroll, Karen C; Perl, Trish M.

In: Emerging Infectious Diseases, Vol. 15, No. 1, 01.2009, p. 12-18.

Research output: Contribution to journalArticle

Maragakis, Lisa ; Chaiwarith, Romanee ; Srinivasan, Arjun ; Torriani, Francesca J. ; Avdic, Edina ; Lee, Andrew ; Ross, Tracy R. ; Carroll, Karen C ; Perl, Trish M. / Sphingomonas paucimobilis bloodstream infections associated with contaminated intravenous fentanyl. In: Emerging Infectious Diseases. 2009 ; Vol. 15, No. 1. pp. 12-18.
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