Published online June 19, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. e212-e215 (doi:10.1542/10.1542/peds.2005-2617)
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EXPERIENCE AND REASON

Life-Threatening Sepsis Caused by Burkholderia cepacia From Contaminated Intravenous Flush Solutions Prepared by a Compounding Pharmacy in Another State

Melissa R. Held, MDa, Elizabeth M. Begier, MD, MPHb,c, Diana S. Beardsley, MDd, Frederick A. Browne, MDe, Richard A. Martinello, MDa,f,g, Robert S. Baltimore, MDa,h, L. Clifford McDonald, MDi, Bette Jensen, MMSci, James L. Hadler, MD, MPHb and Louise-Marie Dembry, MDg,h

a Department of Pediatrics, Division of Infectious Diseases
d Department of Pediatrics, Division of Hematology/Oncology
g Internal Medicine
h Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
b Infectious Disease Division, Connecticut Department of Public Health, Hartford, Connecticut
c Epidemic Intelligence Service Program
i Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
e Department of Laboratory Medicine, Yale-New Haven Hospital, New Haven, Connecticut
f Department of Internal Medicine and the Clinical Epidemiological Research Center, VA Connecticut Healthcare System, West Haven, Connecticut

We report 2 life-threatening cases of Burkholderia cepacia sepsis caused by infusate contamination during compounding. Bacterial isolates from the patients' blood cultures and the infusate were indistinguishable by pulsed-field gel electrophoresis. Proper quality controls at a local and national level are important for ensuring safe delivery of compounded medications to patients in all settings, including those outside health care facilities.

Key Words: Burkholderia cepacia • compounding • contamination • antibiotic-lock solution • sepsis

Abbreviations: CDC, Centers for Disease Control and Prevention • FDA, Food and Drug Administration • PFGE, pulsed-field gel electrophoresis USP, US Pharmacopeia

Accepted Jan 12, 2006.


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