Sphingomonas paucimobilis bloodstream infections associated with contaminated intravenous fentanyl

Lisa L. 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

46 Scopus citations

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 1 2009

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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    Maragakis, L. L., Chaiwarith, R., Srinivasan, A., Torriani, F. J., Avdic, E., Lee, A., Ross, T. R., Carroll, K. C., & Perl, T. M. (2009). Sphingomonas paucimobilis bloodstream infections associated with contaminated intravenous fentanyl. Emerging Infectious Diseases, 15(1), 12-18. https://doi.org/10.3201/eid1501.081054