Hostname: page-component-848d4c4894-8bljj Total loading time: 0 Render date: 2024-07-08T05:22:27.323Z Has data issue: false hasContentIssue false
  • English
  • Français

Serratia Marcescens Meningitis Associated With a Contaminated Benzalkonium Chloride Solution

Published online by Cambridge University Press:  02 January 2015

Robert L. Sautter ,
L.H. Mattman  and
Ruben C. Legaspi
Robert L. Sautter*
Affiliation:
Department of Biological Sciences, Wayne State University, Detroit, Michigan
L.H. Mattman
Affiliation:
Department of Medicine, Wayne State University, Detroit, Michigan
Ruben C. Legaspi
Affiliation:
Department of Internal Medicine and Infectious Disease, South Macomb Hospital, Warren, Michigan
*
Harrisburg Hospital, Harrisburg, PA 17101
Get access Rights & Permissions [Opens in a new window]

Abstract

Serratia marcescens is recognized as an important and potentially hazardous nosocomial pathogen. The organism has been implicated here as the first reported case of S. marcescens meningitis associated with skin disinfection. A quaternary ammonium compound (QAC—Benzalkonium Chloride), was used to sterilize the skin prior to injection in a physician's office. Epidemiological studies were initiated. Six spray bottles containing disinfectant, the opened stock bottle of QAC, and an unopened bottle of disinfectant were all cultured. S. marcescens was noted growing in the spray bottles as well as in the opened stock bottle. Anti-biograms of the patient and epidemiological isolates are essentially the same. It is our contention as well as that of the Centers for Disease Control that an appropriate skin disinfectant such as Tincture of Chlorhexidine, Iodophors, or Tincture of Iodine should be used, and that physicians performing surgical techniques in the office be aware of the potential hazard of contamination. The consequences of nosocomial infection with resistant organisms warrant every precaution by health care professionals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 5 , May 1984 , pp. 223 - 225
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Malizia, WF, Gangarosa, EJ, Goley, AF, Benzalkonium chloride as a source of infection. N Engl J Med 1960;263:800–802.CrossRefGoogle ScholarPubMed
2.Mangi, RJ, Quintiliani, R, Andriole, VT, Gram-negative bacillary meningitis. Am J Med 1975;59:829–836.CrossRefGoogle ScholarPubMed
3.Mills, J, Drew, D, Serratia marcescens endocarditis: A regional illness associated with intravenous drug abuse. Ann Intern Med 1976;84:29–34.Google Scholar
4.Donovan, TL, Chapman, MW, Harrington, KD, et al: Serratia arthritis. J Bone Joint Surg 1976;54A,1009–1011.Google Scholar
5.Fishbach, RS, Rosenblatt, JE, Dahlgren, JG, Pyogenic vertebral osteomyelitis in heroin addicts. Calif Med 1965;119:956–960.Google Scholar
6.Ross, GN, Baraff, LJ, Quismorio, FP, Serratia arthritis in heroin users. J Bone Joint Surg 1975;57A,1158–1160.Google Scholar
7.Graber, CD, Higgins, LS, Davis, JS, Seldom-encountered agents of bacterial meningitis. JAMA 1965;192:956–960.Google Scholar
8.Kakashima, AK, Highsmith, AK, Allen, JR, et al: Serratia marcescens joint infections following intraarticular injections. Abstracts of Annual Meetings of the American Society of Microbiology, 1983, p L6.Google Scholar
9.Guidelines for the Prevention and Control of Nosocomial Infections, Washington, DC, US Department of Health, Education and Welfare, Feb 1981, p 5.Google Scholar
10.Dixon, RE, Caslow, RA, Mackel, DC, et al: Aqueous quat or navy ammonium antiseptics and disinfectants use and misuse. JAMA 1976;236:2415–2417.Google Scholar
11.Adair, FW, Geftic, SG, Gelzer, J: Resistance oi pseudomonas to quaternary ammonium compounds. I. Growth in benzalkonium chloride solution. Appl Microbiol 1969;18:299–302.Google Scholar
12.John, JF, Twitty, JA, Pseudobacteremia with plasmid-containing Pseudomonas cepacia: Contamination of rayon balls in benzalkonium chloride. Bacteriology Proceedings of the American Society of Microbiology, 1982, p L6.Google Scholar
13.Barriere, SL, Conte, JE, Emergence of multiple antibiotic resistance during the therapy of Klebsiella pneumoniae meningitis. Am J Med Sci 1980;279:61–65.Google Scholar