Notice to Readers
Enterobacter cloacae Bloodstream Infections Associated with
Contaminated Prefilled Saline Syringes -- California, November 1998
During November 2-5, 1998, 11 children who received outpatient
therapy from the hematology/oncology service at a hospital in
California developed sepsis; 10 had Enterobacter cloacae-positive
blood cultures. All patients had received intravascular catheter
flushes using prefilled saline syringes (CAPS, Braun-McGaw,
Detroit, Michigan). Culture of an unopened prefilled syringe grew
E. cloacae with identical biochemical profiles to that of the
patients. On November 9, the manufacturer initiated a recall of the
syringes.
Clinicians detecting episodes of sepsis or bloodstream
infection associated with prefilled saline syringes are requested
to report these episodes to ÐÇ¿ÕÓéÀÖ¹ÙÍø's Hospital Infections Program,
National Center for Infectious Diseases, telephone (404) 639-6413;
fax (404) 639-6459; and to MedWatch, the Food and Drug
Administration's Medical Products Reporting Program, telephone
(800) 332-1088; fax (800) 332-0178; address: MedWatch, 5600 Fishers
Lane, Rockville MD 20852-9787; or on the World-Wide Web,
http://www.fda.gov/medwatch.
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