State and federal health officials are investigating the deaths of nine patients at six hospitals who were all given an intravenous nutritional supplement that investigators have found was contaminated by bacteria. Ten other patients who received the supplement also were sickened by the bacteria, called Serratia marcescens, which is most commonly found in water, including some tap water, and sometimes in bathrooms. It can be introduced into the bloodstream via contaminated fluid administered through a catheter.
A medical officer with the Centers for Disease Control and Prevention, said the investigation into the outbreak at six hospitals would not conclude for at least a week. But he said similar investigations in the past typically determined that contamination occurred during the mixing of intravenous supplements. “Historically, what we’ve seen is a breakdown in the manufacturing process,” he said.The state health officer, emphasized that it remained unclear whether the deaths were due to the bacteria or to underlying serious illnesses. “I cannot ascribe those nine deaths to the Serratia marcescens,” he said. “These were patients who were getting treatment, so they were by definition ill.” State officials have identified the source of the supplement, which is known as Total Parenteral Nutrition, or T.P.N., at a local pharmacy in, a compounding pharmacy that makes medications that do not come premixed.State officials said the pharmacy has stopped distributing the supplement and was no longer open. They said it was unlikely the company would reopen, adding that it had made the decision to close on its own. The state health department said that about 35 percent of the patients who received T.P.N.sustained infections. The first two occurrences were in January and February, she said. The affected patients ranged in age from 38 to 94. Eleven were women and eight were men. He said there was little chance that other patients would become infected, although he said officials were making sure the supplement had been entirely removed from all health facilities. “Right now it looks like we have a contained and closed problem,” he said.The supplement is typically administered to patients whose gastrointestinal systems are not working properly, including those undergoing chemotherapy or recovering from major surgery. The mix is delivered to hospitals in containers presumed to be sterile and has a limited shelf life. The state health department had been notified about Serratia marcescens infections by two area hospitals,The state then sought assistance from the Centers for Disease Control, which was able to track the outbreak to the pharmacy. Soon after, the pharmacy notified customers about the contamination, and it voluntarily recalled the product.A statement issued by Health System, which operates 2 of the hospitals said six of the nine deaths had occurred at those medical centers. A total of seven patients were infected at one hospital, four of whom died, and five were sickened at another, two of whom died. “Because quality patient care is our top priority, this event is deeply disturbing to all of us,” the group’s chief medical officer, said in the statement. She added, “We don’t know, and may never know, if the Serratia marcescens bloodstream infection played a role in the deaths of these patients.”The health system also said it had ended its relationship with the pharmacy, and noted that “as a precaution, we have removed all other products from the supplier.” A spokeswoman for the parent company of a local hospital, which had one infection-associated death, said in a statement that the pharmacy was “universally believed and considered to be a reputable and trustworthy entity.” A spokeswoman for another hospital said the hospital discovered that three patients had been infected with the bacteria, and treated them with antibiotics. One of those patients died. “I can say it was a critically ill patient,” she said.
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