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Felix A. Sarubbi, Jr, MD; M. Brejetta Wilson, RN; Marianne Lee, RN; Charles Brokopp, DPH

JAMA. 1978;239(5):416-418.

Abstract
Nosocomial Gram-negative bacillary meningitis and bacteremia occurred in a patient who was receiving intrathecal and intravenous amphotericin B. An epidemiologic investigation found the amphotericin B to be contaminated with Enterobacter agglomerans, Pseudomonas fluorescens, and P aeruginosa. These contaminants were traced to a lot of sodium phosphate buffer that was added to all intrathecal and intravenous amphotericin B preparations. The phosphate buffer underwent prolonged storage at room temperature and was not subject to terminal sterilization nor sterility testing. This parenteral admixture prepared in the hospital is now steam autoclaved and sterility tested before use.

(JAMA 239:416-418, 1978)

Author Affiliations
From the Department of Medicine (Dr Sarubbi), University of North Carolina School of Medicine, Chapel Hill; the Department of Hospital Epidemiology (Dr Sarubbi, Ms Wilson, and Ms Lee), North Carolina Memorial Hospital, Chapel Hill; and the Department of Parasitology and Laboratory Practice (Dr Brokopp), University of North Carolina School of Public Health, Chapel Hill.

Footnotes
Reprint requests to Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC 27514 (Dr Sarubbi).

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