Bloodstream infections originating from tainted intravenous (IV) products appear to be the cause of nearly three-dozen patient illnesses in New York nursing homes. One patient death is also being reviewed as part of a New York State Department of Health investigation; investigations are ongoing in Maryland, New Jersey, and Pennsylvania that involve the same pathogen and potentially tainted intravenous products.
The health department is looking into 54 facilities—most in Manhattan and six on Long Island—that purchased the IV products, according to Newsday. State officials do not know the cause of the one death and are only able to identify the products as IV medications and “flushes” that may include sterile saline used to infuse an IV tube connected to a patient to clear the line of obstructions. The health department did not give the names of manufacturers or distributors, but did indicate that the products originated from two companies. One company supplies pharmacy services to nursing homes in New York’s greater metropolitan region; the second manufactures medical products that include saline flushes.
Regarding the patient death, James Plastiras, a spokesman for the health department said that, “the cause of death has not been determined and we cannot say the infection caused the death,” according to Newsday. Plastiras did not indicate where in New York the death took place. The state did name the 54 facilities, but did not name those associated with the infections.
The health department indicated that its data revealed that the IV products were tainted with bacteria known as Burkholderia cepacia (B. cepacia). The U.S. Centers for Disease Control and Prevention (CDC) describe B. cepacia as being either a group or a bacterial complex and the microbes involved are typically associated with soil or water. While harmless in healthy people, the bacteria may be serious, even deadly, to people with a weakened immunity or who suffer from chronic lung diseases, according to Newsday.
B. cepacia has become progressively more resistant to antibiotics, the CDC notes, and tend to reject the medications that have developed to destroy them. Infections become very challenging to treat when caused by drug-resistant microbes, such as B. cepacia, according to Dr. Luis Martinez, associate professor in the department of biomedical science at New York Institute of Technology’s College of Osteopathic Medicine in Old Westbury, New York. Dr. Martinez described B. cepacia as a Gram negative bacterium, meaning that it is structurally complex and containing a double membrane. Most gram negative bacteria, such as drug resistant E. coli, he said, are difficult to fight because not many antibiotics have been developed in recent years and barely any for gram negative bacteria, according to Dr. Martinez, Newsday wrote.
“As soon as we learned about the potential contamination we immediately notified the 54 impacted long-term-care facilities that received medications or flushes from one or both of those companies, and advised them to inform their patients who could have been exposed to the bacteria,” Dr. Howard Zucker, New York State Health Commissioner said in a statement, Newsday reported. “We also instructed the facilities to refrain from using certain intravenous products, and have helped them to locate necessary medical supplies to maintain services and protect the health of their patients,” Zucker added.