TPN contamination

[Guest guest]

The Alabama Department of Public Health today is announcing an ongoing

investigation of an outbreak of *Serratia marcescens* bacteremia in six

Alabama hospitals. On March 16, ADPH was notified that an outbreak had

occurred in two of these hospitals among patients receiving TPN (total

parenteral nutrition).

TPN is liquid nutrition fed through an IV using a catheter. Use of

contaminated products may lead to bacterial infection of the blood.

ADPH requested assistance from the Centers for Disease Control and

Prevention. CDC's initial investigation identified TPN produced by a single

pharmacy, Meds IV, as a potential common source and has determined that

these hospitals received TPN from this pharmacy. Affected hospitals are

Baptist Princeton, Baptist Shelby, Baptist Prattville, Medical West,

Green Mercy and Select Specialty Hospital in Birmingham.

Meds IV was notified and informed its customers of the possibility of

contamination. ADPH has been informed that impacted hospitals immediately

stopped using TPN received from this pharmacy and that the pharmacy

discontinued all production. On March 24, Meds IV recalled all of its IV

compounded products. The U.S. Food and Drug Administration is aware of the

voluntary recall. The pharmacy and the hospitals are cooperating with the

investigation.

At this time, ADPH is aware of 19 cases in these six hospitals of *Serratia

marcescens* bacteremia related to this outbreak.

ADPH will provide updates as more information becomes available.

*Product List*

- *Bronch Procedure Kit*

- *Bupivacaine Epidural Bag*

- *Cardioplegia Solutions*

- *Cefazolin 2 gm Syringe*

- *Dialysate Solution*

- *Fentanyl /Ropivacaine Epidural Bag*

- *Fentanyl/ Bupivacaine Epidural Bag*

- *Folic Acid 1mg/0.2ml Syringe*

- *Glycopyrrolate 0.2mg/ml 1ml in 3ml Syringe*

- *Heparin IV Bags*

- *Hydromorphone Intravia Bag*

- *Hydromorphone PCA Syringe*

- *Ketamine Syringe*

- *Labetalol syringe*

- *Lorazepam 2mg/ml syr*

- *Meperidine 10mg/100ml NS(Intravia Bag)*

- *Morphine 1mg/ml PCA 100ml Intravia Bag*

- *Neostigmine 3mg Syringe*

- *Nitroglycerin IV Bag*

- *Nitroglycerin Syringe*

- *Norepinehrine IV Bag*

- *Oxytocin Bags*

- *Sodium Chl 23.4% (4meq/ml) 10ml Syr*

- *Succinylcholine 20mg/ml 5ml Syringe*

- *TPN Solution*

- *Vancomycin IV Bag*

link <http://www.fda.gov/Safety/Recalls/ucm249068.htm>

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

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