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Investigations of Intrinsic Pseudomonas cepacia Contamination in Commercially Manufactured Povidone-Iodine

Published online by Cambridge University Press:  21 June 2016

Roger L. Anderson ,
Robert W. Vess ,
Janice H. Carr ,
Walter W. Bond ,
Adelisa L. Panlilio  and
Martin S. Favero
Roger L. Anderson*
Affiliation:
Hospital Infections Program, Centers for Disease Control (CDC), Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Robert W. Vess
Affiliation:
Hospital Infections Program, Centers for Disease Control (CDC), Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Janice H. Carr
Affiliation:
Hospital Infections Program, Centers for Disease Control (CDC), Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Walter W. Bond
Affiliation:
Hospital Infections Program, Centers for Disease Control (CDC), Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Adelisa L. Panlilio
Affiliation:
Hospital Infections Program, Centers for Disease Control (CDC), Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
Martin S. Favero
Affiliation:
Hospital Infections Program, Centers for Disease Control (CDC), Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia
*
Hospital Infections Program, CDC, 1600 Clifton Road, 1-B341, Atlanta, GA 30333
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Abstract

Objective:

Laboratory investigations were initiated with a povidone-iodine antiseptic solution that was intrinsically contaminated with Pseudomonas cepacia. These investigations were helpful in understanding the microbicidal and chemical properties of iodophor solutions and the mechanism by which P cepacia can survive in iodine-containing antiseptics.

Design:

Included in these studies were: prolonged survival of P cepacia; available and free iodine determinations; microbial challenge studies; and scanning electron microscopic examination of contaminated antiseptic.

Results:

P cepacia survived in this iodophor antiseptic up to 68 weeks from the date of manufacture. A uniform concentration of 1% available iodine was found in all lots of povidone-iodine tested as specified on the product label, but free iodine (I,) values varied greatly. Low free iodine levels of 0.23 to 0.46 ppm were associated with the contaminated lot of povidone-iodine. Solutions of povidone-iodine with varying levels of free iodine were rapidly microbicidal when challenged with cells of P cepacia derived from culture broth and washed or adapted to growth in water. P cepacia cells taken directly from contaminated povidone-iodine survived for significantly longer periods of time. Large numbers of P cepacia were found embedded in extracellular material and among strands of glycocalyx between cells as shown by scanning electron microscopy.

Conclusions:

The physical thickness of cellular and extracellular material that forms on surfaces could protect embedded organisms from the microbicidal action of disinfectants and antiseptics and subsequently allow for extended microbial survival times. Manufacturers should be aware that distribution piping surfaces colonized with bacteria may be a source of product contamination and resistant organisms.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 5 , May 1991 , pp. 297 - 302
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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References

1. Centers for Disease Control. Contaminated povidoneiodine solution-Texas. MMWR. 1989;38:133–134.Google Scholar
2. Berkelman, RL, Levin, S, Allen, JR, et al. Pseudobacteremia attributed to contamination of povidone-iodine with Pseudomonas cepacia . Ann Intern Med. 1981;95:32–36.10.7326/0003-4819-95-1-32CrossRefGoogle ScholarPubMed
3. Craven, DE, Moody, B, Connolly, MG, et al. Pseudobacteremia caused by povidone-iodine solution contaminated with Pseudomonascepacia . N Engl J Med. 1981;305:621–623.10.1056/NEJM198109103051106Google Scholar
4. Centers for Disease Control. Pseudomonas aeruginosa peritonitis attributed to a contaminated iodophor solution-Georgia. MMWR. 1982;31:197–198.Google Scholar
5. Parrott, PL, Terry, PM, Whitworth, EN, et al. Pseudomonas aeruginosa peritonitis associated with contaminated poloxameriodine solution. Lancet. 1982;2:683–685.Google Scholar
6. Carson, LA, Petersen, NJ, Favero, MS, et al. Growth characteristics of atypical mycobacteria in water and their comparative resistance to disinfectants. Appl Environ Microbiol. 1978;36:839–846.10.1128/aem.36.6.839-846.1978Google Scholar
7. Carson, LA, Favero, MS, Bond, WW, et al. Factors affecting comparative resistance of naturally occurring and subcultured Pseudomonas aeruginosa to disinfectants. Appl Microbial. 1972;23:863–869.10.1128/am.23.5.863-869.1972Google Scholar
8. Berkelman, RL, Anderson, RL, Davis, BJ, et al. Intrinsic bacterial contamination of a commercial iodophor solution: investigation of the implicated manufacturing plant. Appl Environ Microbial. 1984;47:752–756.10.1128/aem.47.4.752-756.1984Google Scholar
9. Anderson, RL, Berkelman, RL, Mackel, DC, et al. Investigations into the survival of Pseudomonas aeruginosa in poloxamer-iodine. Appl Environ Microbiol. 1984;47:757–769.10.1128/aem.47.4.757-762.1984CrossRefGoogle ScholarPubMed
10. U.S. Pharmacopeia. Povidone-iodine topical solution. Official Monographs. Vol. 20. Easton, Penn: Mack Publishing Co.; 1980:648.Google Scholar
11. Schmidt, W, Winicov, M. Detergent/iodine systems. Soap Ckem Spec. 1967;43:61–64.Google Scholar
12. Costerton, JW, Lappin-Scott, HM. Behavior of bacteria in biofilms. ASM News. 1989;55:650–654.Google Scholar
13. Costerton, JW, Nickel, JC, Marrie, TJ. The role of the bacterial glycocalyx and of the biofilm mode of growth in bacterial pathogenesis. In: Moellering, RC, ed. Rocke Seminars on Bacteria. No. 2. Nutley, NJ: Hoffman-LaRoche Inc.; 1985:1–25.Google Scholar
14. Costerton, JW, Irvin, RT, Cheng, K-J. The bacterial glycocalyx in nature and disease. Annual Rev Microbiol. 1981;35:299–324.10.1146/annurev.mi.35.100181.001503Google Scholar
15. Anderson, RL. Iodophor antiseptics: intrinsic microbial contamination with resistant bacteria. Infect Control Hosp Epidemiol. 1989;10:443–446.10.2307/30146832Google Scholar
16. Anderson, RL, Holland, BW, Carr, JK, et al. Effect of disinfectants on pseudomonads colonized on the interior surface of PVC pipes. Am J Public Health. 1990;80:17–21.10.2105/AJPH.80.1.17Google Scholar
17. Anderson, RL, Vess, RW, Panlilio, AL, Favero, MS. Prolonged survival of Pseudomonas cepacia in commercially manufactured povidone-iodine. Appl Environ Microbiol. 1990;56:3598–3600.10.1128/aem.56.11.3598-3600.1990Google Scholar
18. Favero, MS. Iodine-champagne in a tin cup. Infect Control. 1982;3:30–32.Google Scholar
19. Favero, MS. Sterilization, disinfection, and antisepsis in the hospital. In: Lennette, EH, Balows, A, Hausler, WJ, Shadomy, HJ, eds. Manual of Clinical Microbiology. 4th ed. Washington, D.C.: American Society for Microbiology; 1985:129–137.Google Scholar