Alabama Hospital Outbreak Tied to Poor Sterilization

The deadly bacterial outbreak that led to infections in 19 patients at six Alabama hospitals was most probably caused by a sterilization process gone wrong. Nine people died as a result of the infection believed to be linked to tainted IV feeding solution.

According to Reuters, health officials can not confirm if the nine <"">Alabama hospital outbreak deaths were directly attributable to poor sterilization, which led to the Serratia marcescens bacteremia, a pathogen that can cause serious infections. All 19 patients received total parenteral nutrition (TPN), which is a feeding solution injected intravenously to patients unable to eat by mouth or a feeding tube, Reuters explained.

In our last report, we wrote that Alabama Department of Public Health director, Dr. Donald Williamson, said that the type of bacteria identified on the IV feeding bags matches the type found on a sink and in production areas at Meds IV. Reuters now says that tests revealed that the pathogen in the nutritional solution at a Birmingham pharmacy was the same strain found in blood samples from 12 of the patients, according to Williamson. This finding eliminates the potential for the infection to have been caused by anything other than the solution.

Williamson noted that the investigation continues to determine if the filter used during sterilization is the culprit of if there was a problem in how procedures were carried out, wrote Reuters. “We are not done…. We’ll be working with the regulatory entities to try to understand exactly what went wrong in the sterilizing process,” Williamson said during a conference call with reporters, quoted Reuters. “We’ve identified where the weak point in the chain of infection control occurred…. We’re now trying to identify exactly what happened,” he added.

Officials connected to the case said the probe will continue for several more weeks, wrote Reuters, and noted that those infected ranged in age from 38 to 94; 17 cases were reported last month and two others were reported in January and February.

As of Thursday, the families of patients infected at the Alabama hospitals filed four lawsuits against Meds IV and some of the hospitals, said Reuters. Donald J. Mottern filed on behalf of his mother, LaVonne, 71, who died. “I would just like to have confidence back in our healthcare system,” he said, quoted Reuters. Another wrongful death lawsuit was filed against Meds IV on behalf of Mary Ellen Kise, who died at Baptist Health Systems hospitals after receiving feeding treatment. The families of two other deceased patients and one patient who suffered brain injuries after receiving IV feeding with Meds IV products are also pursuing legal action.

The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) identified the six Alabama hospitals: Princeton Baptist Medical Center; Shelby Baptist Medical Center; Cooper Green Mercy Hospital; Medical West; Prattville Baptist Hospital; and Select Specialty Hospital, a long-term acute care hospital that is part of the Trinity Medical Center.

The serratia marcescens bacteremia pathogen can lead to urinary tract, respiratory tract, optical, and wound infections, with the main risk factor being sepsis. Other diseases linked include meningitis, cerebral abscess, osteomyelitis, and arthritis; most S. marcescens strains are resistant to several antibiotics.

On March 24, Meds IV recalled all of its IV compounded products.

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