Indwelling Catheter Patients at Risk for Delayed Infection

Patients treated with recalled batch of heparin flush developed infections months after exposure

FRIDAY, Sept. 8 (HealthDay News) -- Patients with implantable venous catheters who were exposed to Pseudomonas fluorescens due to contaminated syringes preloaded with heparin intravenous catheter flush are at risk for bloodstream infections up to 14 months after receiving their last contaminated injection, according to a report in the Sept. 8 issue of the Morbidity and Mortality Weekly Report. The contaminated syringes, prepared by IV Flush, LLC of Rowlett, Texas, were recalled across the United States in early 2005.

Health officials from South Dakota and Michigan reviewed the records of 28 cancer patients with indwelling central venous catheters who were diagnosed with bloodstream infections between April 2005 and March 2006. Of the 28 patients, 27 (96 percent) experienced chills within eight hours of receiving an uncontaminated flush.

Bacteria recovered from blood and catheter cultures from the 28 patients were genetically indistinguishable from or closely related to those found in the earlier outbreak. They also determined that the bacteria formed biofilms and remained in the lining of the catheters. The bacteria were released after a new, uncontaminated heparin flush was used.

"Health care providers should conduct ongoing surveillance and be aware of possible bloodstream infection in patients with indwelling catheters who have received contaminated injections, even several months after exposure. Catheter removal in such instances is strongly recommended, especially among immunocompromised patients, because antibiotic therapy alone might not eradicate P. fluorescens from catheter biofilms," the researchers conclude.

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