Unusual cause of pseudomonal infection

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6974.258c (Published 28 January 1995) Cite this as: BMJ 1995;310:258
  1. R Levy,
  2. D T Hindley,
  3. R Burman,
  4. S A Haider,
  5. J Blease
  1. Registrar in paediatrics Consultant paediatrician Consultant microbiologist Consultant paediatrician Sister in charge, special care baby unit Fairfield General Hospital, Bury, Lancashire BL9 7TD

    EDITOR,—In the light of recent reports of unusual sources of pseudomonal infection,1 2 3 we wish to report on a preterm infant receiving intensive care in our neonatal unit. He was born at 33 weeks' gestation and required intermittent positive pressure ventilation for the respiratory distress syndrome of prematurity. Delivery was vaginal, there was no history of prolonged rupture of membranes, and surface swabs at birth yielded negative results. After 10 days his condition deteriorated. Clinical and laboratory indicators suggested sepsis with disseminated intravascular coagulation, and blood cultures obtained on three occasions grew Pseudomonas cepacia. Isolation of this unusual organism prompted liaison with our microbiology colleagues, and a full environmental screen showed the same organism (confirmed by chromosomal digest with pulsed field gel electro-phoresis) in the humidification unit of the blood gas analyser.

    The baby recovered with treatment with appropriate antibiotics. The procedure for ensuring hygienic use of the blood gas analyser was reviewed and updated, and staff using the machine were made aware of the new policy. How the organism was transferred to the baby on this occasion remains a matter for speculation.


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