This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A Case for Selective Drug Screening of Health Care Personnel

Dennis G. Maki, MD; Bruce S. Klein, MD; Rita D. McCormick, RN; Carla J. Alvarado, MS; Mary Ann Zilz, RN; Susan M. Stolz, MS; Carol A. Hassemer, MS; Joanne Gould, MD; Allen R. Liegel, MS, RPh

JAMA. 1991;265(8):981-986.

Abstract
Three patients in a university hospital developed nosocomial infusion-related Pseudomonas pickettii bacteremia. Investigation identified six additional patients who had received intravenous fluid contaminated by P pickettii but did not become ill. All nine patients had had surgery, and each of these patients but only nine of 19 operated-on control patients had received intravenous fentanyl citrate in the operating room; the mean dose given to the nine case patients was far greater than that given to control patients. Fentanyl in 20 (40%) of 50 predrawn 30-mL syringes was shown to be contaminated by P pickettii. Contamination was caused by theft of fentanyl from predrawn syringes and replacement by distilled water contaminated by P pickettii. Narcotic theft by health care personnel may cause patients to suffer pain needlessly and can also result in dire unanticipated consequences, such as nosocomial bacteremia. Whereas drug testing in the workplace is highly controversial, we believe that testing of health care personnel is indicated when drug abuse or theft is suspected.

(JAMA. 1991;265:981-986)

Author Affiliations
From the Infection Control Department (Drs Maki, Klein, and Gould and Mss McCormick, Alvarado, Zilz, Stolz, and Hassemer) and the Hospital Pharmacy (Mr Liegel), University of Wisconsin Hospital and Clinics, and the Section of Infectious Disease, Departments of Medicine (Dr Maki) and Pediatrics (Dr Klein), University of Wisconsin Medical School, Madison.

Footnotes
Presented in part at the Twenty-Fourth Interscience Conference on Antimicrobial Agents and Chemotherapy, Minneapolis, Minn, October 2,1985.

Reprint requests to H4/574, University of Wisconsin Hospital and Clinics, Madison, WI 53792 (Dr Maki).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Ralstonia pickettii Traced in Blood Culture Bottles
Boutros et al.
J. Clin. Microbiol. 2002;40:2666-2667.
ABSTRACT | FULL TEXT  

Serratia marcescens Bacteremia Traced to an Infused Narcotic
Ostrowsky et al.
NEJM 2002;346:1529-1537.
ABSTRACT | FULL TEXT  

Nosocomial Bacteremia and Drug Theft: Epidemiology Finds the Solution
McGowan
JAMA 1991;265:1021-1022.
ABSTRACT