Risk factors for development of sepsis in a hospital outbreak of enterobacter aerogenes

On Feb. 24, 1986, a consultant in infectious disease notified the infection control nurse of two patients in the ICU with Enterobacter aerogenes sepsis. A third case was identified in the same unit 3 days later. Environmental cultures of flushing solutions (normal saline), a temperature probe, a cardiac catheter connector probe, and a syringe attached to a manometer for calibrating pressure transducers were taken on Feb. 28. These items had been used on all patients with bacteremia. The ICU staff members, questioned about high-risk procedures such as the use of multiple-dose vials, denied such use. On March 3, after three more cases of E. aerogenes sepsis had been identified, active surveillance was begun of one afebrile patient undergoing elective cardiac surgery that involved taking preoperative and postoperative cultures of blood, skin, catheter insertion sites,