Abstract
Between September, 1981, and April, 1984, Ewingella americana was recovered from blood cultures from 21 patients in the intensive care units and emergency room of a 265-bed pediatric hospital. Because clinical presentations were generally not suggestive of Gram-negative bacteremia, we began an epidemiologic investigation for a source of pseudobacteremia. E. americana is a new genus and species in the family Enterobaeteriaceae, previously known as CDC enteric group 40. It has been reported as a pathogen only once. A case-control study showed that cases were much more likely than controls to have had blood obtained for coagulation profiles with cultures (15/19 vs. 4/39 controls, p = 3.4 × 10−7). Coagulation tubes had been prepared with crystalline sodium citrate and citric acid in distilled deionized water. Blood for both coagulation studies and culture was occasionally instilled into the screw-top coagulation tube before blood culture bottles were inoculated. We hypothesized that if the citrate solution were contaminated, the needle or syringe hub could have transferred E. americana to the blood culture bottles, resulting in false positives. E. americana was recovered from all of 80 unused coagulation tubes and from no other environmental sources. Personnel obtaining blood for multiple studies should adhere to strict aseptic technique. Laboratories should consider using sterile evacuated coagulation tubes rather than tubes containing potentially contaminated home-made anticoagulant.
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Gardner, S., Rabat, K. & Shulman, S. 538 AN OUTBREAK OF PSEUDOBACTEREMIA CAUSED BY EWINGELLA AMERICANA. Pediatr Res 19, 200 (1985). https://doi.org/10.1203/00006450-198504000-00568
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DOI: https://doi.org/10.1203/00006450-198504000-00568