Journal Article

<i>Enterobacter cloacae</i> Bloodstream Infections Traced to Contaminated Human Albumin

Susan A. Wang, Jerome I. Tokars, Peter J. Bianchine, Loretta A. Carson, Matthew J. Arduino, Arline L. Smith, Nancy C. Hansen, Edward A. Fitzgerald, Jay S. Epstein and William R. Jarvis

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 1, pages 35-40
Published in print January 2000 | ISSN: 1058-4838
Published online January 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313585
Enterobacter cloacae Bloodstream Infections Traced to Contaminated Human Albumin

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In August 1996, a patient in Kansas developed an Enterobacter cloacae bloodstream infection (BSI) shortly after receiving Albuminar, a brand of human albumin. Albuminar contamination was suspected. A case-control study of patients with primary gram-negative bacterial BSIs showed that patients with E. cloacae BSIs were significantly more likely than patients with non-E. cloacae gram-negative BSIs to have received Albuminar within 3 days of developing their BSIs (3 of 5 vs. 0 of 9; OR, undefined; P = .03). The E. cloacae isolate from the Kansas patient was found by pulsed-field gel electrophoresis to be identical to the isolate from the patient's Albuminar vial, to isolates from 2 previously unopened Albuminar vials, and to an isolate from a Wisconsin patient who had received Albuminar. A worldwide recall of ∼116,000 Albuminar vials took place. This multistate outbreak was detected because of clinical astuteness and prompt reporting. Combined epidemiological and laboratory approaches are valuable when investigating potentially contaminated blood components and plasma derivatives.

Journal Article.  3682 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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