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STAPHYLOCOCCUS AUREUS, CONTAMINATED INJECTIONS - USA: (FLORIDA), ALERT
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Fri 4 Apr 2008
Source: Tallahassee.com [edited]
http://www.tallahassee.com/apps/pbcs.dll/article?AID=/20080406/NEWS01/804060312/1010

The Florida Department of Health is waiting on the results of lab
tests to determine what caused an outbreak of _Staphylococcus aureus_
infections among 12 people treated at a Tallahassee pain clinic.

Officials from the Leon County Health Department, who have been
tracking the cases, say they are not MRSA, the drug-resistant form of
the bacterium. Four other patients were hospitalized for observations
but were not confirmed as having staphylococcal infections, said Page
Jolly, spokesperson for the Leon County Health Department.

Infectious disease specialists who inspected the Pain Institute of
North Florida ruled out skin contact or unsanitary equipment as a
cause, said Dr. George Arcos, who runs the institute, and the main
focus of the investigation is a batch of medicine that was likely
contaminated. Lab results are expected to arrive early next week,
said Page Jolly.

A 64-year-old woman of Bainbridge, Georgia was one of those infected.
After getting an injection about 2 weeks ago at the Pain Institute of
North Florida, the woman said she felt some relief from her severe
back pain. But then she started experiencing severe pain on her left
side. She began hallucinating, and pretty soon she couldn’t recognize
her own children. She’d scream when touched because the pain was so
great.

Staff from the Pain Institute called her and her husband and told her
to get a blood culture and to report to the emergency room at Capital
Regional Medical Center, she said. She was diagnosed with a _S.
aureus_ infection and began treatment with antibiotics immediately,
her husband said. A week and a half after checking into the hospital
on 24 Mar 2008, she was feeling much better and asking to go home.

17 people were hospitalized for observation or treatment in
connection with the outbreak, and the Leon County Health Department
is asking anyone who received injections from the institute between 1
and 21 Mar 2008 to call (850) 606-8161.

Arcos said that based on the nature of the infections, the outbreak
was likely caused by contaminated medicine. “These injuries were at
the site where the medicine was deposited,” he said. “They’re deep in
the tissues.”

[Byline: Tabitha Yang]

—
Communicated by:
ProMED-mail promed@promedmail.org

[The mechanism of contamination is not clear but could be the use of
a single dose medication vial for multiple patients. If each patient
who was infected received injections from separate vials, the single
dose vials could have been contaminated during production. If this is
the case, more cases should be found in more places. - Mod.LL]

[see also:
2005
Serratia marcesens, contaminated solution - USA (NJ): alert
20050320.0808
2003
Yersiniosis, contaminated blood - Japan 20031009.2538
2002