Evidence map›Paper›PMID 24442075›Full record

ArticleInfection control and hospital epidemiology2014

Pseudo-outbreak of Klebsiella oxytoca spontaneous bacterial peritonitis attributed to contamination of multidose vials of culture medium supplement.

Federico Perez, Abhishek Deshpande, Sirisha Kundrapu, Andrea M Hujer, Robert A Bonomo, Curtis J Donskey

Open access · greenAbstract read
In one paragraph

Article in Infection control and hospital epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 88% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Carbapenemase-producingEmerging microbes & infections · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Federico PerezResearch Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.
Abhishek Deshpande
Sirisha Kundrapu
Andrea M Hujer
Robert A Bonomo
Curtis J Donskey
Case Western Reserve University · USGeriatric Research Education and Clinical Center · USLouis Stokes Cleveland VA Medical Center · USUniversity School · US

Funding

Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Clinical and Translational Science Collaborative of ClevelandKL2TR000440 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$11.1M
Understanding B-Lactam Resistance in Acinetobacter baumanniiR01AI072219 · NIAID · CASE WESTERN RESERVE UNIVERSITY · PI ROBERT A. BONOMO, Philip N. Rather · 2007 to 2026
$6.6M
Understanding ceftazidime resistance in SHV B-LactamasesR01AI063517 · NIAID · CASE WESTERN RESERVE UNIVERSITY · PI BONOMO, ROBERT A. · 2005 to 2023
$4.9M
A Mechanism-Based Approach to Metallo-beta-Lactamase InhibitionR01AI100560 · NIAID · CASE WESTERN RESERVE UNIVERSITY · PI BONOMO, ROBERT A., SPENCER, JAMES · 2012 to 2022
$4.4M
NCATS NIH HHS KL2 TR000440NCATS NIH HHS UL1 TR000439NCATS NIH HHS UL1TR000439NIAID NIH HHS R01 AI063517NIAID NIH HHS R01AI063517NIAID NIH HHS R01 AI072219NIAID NIH HHS R01AI072219NIAID NIH HHS R01 AI100560NIAID NIH HHS R01AI100560
6 · The paper itself

Abstract

objectiveTo determine the source of a cluster of Klebsiella oxytoca isolates cultured from peritoneal fluid of 3 patients with cirrhosis on a single day.

designOutbreak investigation and before-after study.

settingA Veterans Affairs medical center.

methodsEpidemiologic investigation, analysis of antimicrobial susceptibility testing results and molecular typing of K. oxytoca isolates with repetitive sequence-based polymerase chain reaction (rep-PCR), review of microbiology laboratory procedures for processing peritoneal fluid cultures, and comparison of peritoneal fluid contamination rates 18 months before and after modification of laboratory procedures for culturing peritoneal fluid.

resultsEach of the peritoneal fluid samples that grew K. oxytoca was inoculated into blood culture bottles by different clinicians at different hospital locations. None of the patients had clinical findings suggestive of peritonitis or elevated polymorphonuclear cell counts in peritoneal fluid (range, 3-25 cells/μL). Molecular typing with rep-PCR demonstrated that the K. oxytoca isolates were genetically related (greater than 95% similarity). Laboratory procedures included the routine addition of a culture medium supplement of yeast extract and dextrose from a multidose vial into blood culture bottles with peritoneal fluid. After discontinuing use of the culture medium supplement, there was a marked reduction in the number of peritoneal fluid cultures deemed as contaminants (14.3% vs 0.9%; [Formula: see text]).

conclusionA pseudo-outbreak of K. oxytoca peritonitis and high rates of contamination of peritoneal fluid were attributable to contamination of a multidose culture medium supplement. This article highlights the importance of discouraging the use of multidose vials in all clinical settings.

Indexed as

Culture MediaEquipment ContaminationKlebsiella oxytocaAdultAscitic FluidCross InfectionDisease OutbreaksFalse Positive ReactionsHumansKlebsiella InfectionsMaleMiddle AgedOhioPeritonitisCulture Media

Identifiers

PMID24442075
PMCPMC3957413
OpenAlexW2072207240

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.