An Outbreak of Postoperative Gram-Negative Bacterial Endophthalmitis Associated with Contaminated Trypan Blue Ophthalmic Solution

We report 6 cases of postsurgical endophthalmitis due to gram-negative bacteria associated with contaminated trypan blue dye from a compounding pharmacy. Unopened trypan blue syringes yielded Pseudomonas aeruginosa and Burkholderia cepacia complex on culture, with pulsed-field gel electrophoresis pa...

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Bibliographic Details
Published in:Clinical infectious diseases 2009-06, Vol.48 (11), p.1580-1583
Main Authors: Sunenshine, Rebecca, Schultz, Maureen, Lawrence, Mary G., Shin, Soo, Jensen, Bette, Zubairi, Sabiha, Labriola, Ann M., Shams, Alicia, Noble-Wang, Judith, Arduino, Matthew J., Gordin, Fred, Srinivasan, Arjun
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Bacteria
Biological and medical sciences
Brief Reports
Burkholderia cepacia complex - classification
Burkholderia cepacia complex - genetics
Burkholderia cepacia complex - isolation & purification
Cataracts
Cluster Analysis
Contamination
Cross Infection - epidemiology
Cross Infection - microbiology
Disease Outbreaks
DNA Fingerprinting
Drug Contamination
Electrophoresis, Gel, Pulsed-Field
Endophthalmitis
Endophthalmitis - epidemiology
Endophthalmitis - microbiology
Genotype
Gram-negative bacteria
Gram-Negative Bacterial Infections - epidemiology
Gram-Negative Bacterial Infections - microbiology
Humans
Infectious diseases
Male
Medical sciences
Medical syringes
Medications
Middle Aged
Ophthalmic Solutions
Ophthalmology
Pharmacies
Pseudomonas aeruginosa
Pseudomonas aeruginosa - classification
Pseudomonas aeruginosa - genetics
Pseudomonas aeruginosa - isolation & purification
Surgical specialties
Surgical Wound Infection - epidemiology
Surgical Wound Infection - microbiology
Trypan Blue
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Summary:We report 6 cases of postsurgical endophthalmitis due to gram-negative bacteria associated with contaminated trypan blue dye from a compounding pharmacy. Unopened trypan blue syringes yielded Pseudomonas aeruginosa and Burkholderia cepacia complex on culture, with pulsed-field gel electrophoresis patterns indistinguishable from patient isolates. Contamination of compounded medications should be considered when investigating outbreaks of postoperative endophthalmitis.
ISSN:1058-4838
1537-6591
DOI:10.1086/598938