Serratia liquefaciens Bloodstream Infections from Contamination of Epoetin Alfa at a Hemodialysis Center

• Published in: The New England journal of medicine Vol. 344; no. 20; pp. 1491 - 1497
• Main Authors: Grohskopf, Lisa A, Roth, Virginia R, Feikin, Daniel R, Arduino, Matthew J, Carson, Loretta A, Tokars, Jerome I, Holt, Stacey C, Jensen, Bette J, Hoffman, Richard E, Jarvis, William R
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 17-05-2001
• Subjects: Adult; Aged; Aged, 80 and over; Ambulatory Care Facilities; Bacteremia - epidemiology; Bacteremia - etiology; Bacteremia - microbiology; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Cohort Studies; Colorado - epidemiology; Cosmetics; Cost control; Cross Infection - epidemiology; Cross Infection - etiology; Cross Infection - microbiology; Data Collection; Disease Outbreaks - prevention & control; Drinking water; Drug Contamination - economics; Drug Contamination - prevention & control; Epoetin Alfa; Erythropoietin - administration & dosage; Female; Fever - etiology; Hemodialysis; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Nosocomial infections; Odds Ratio; Patients; Recombinant Proteins; Renal Dialysis; Serratia - classification; Serratia - isolation & purification; Serratia Infections - epidemiology; Serratia Infections - etiology; Serratia Infections - microbiology; Serratia liquefaciens; Soaps; United States; United States; Colorado; United States > US; Water; Human; Nosocomial infection; Statistical analysis; Hemodialysis; Samplings; Epoetin alfa; Soap; Fever; Infection; Extrarenal dialysis; Lotion; Cohort study; Bacteriosis; Microorganism culture; Bacteria; Serratia liquefaciens; Blood culture; Enterobacteriaceae
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM200105173442001

Over 200,000 persons in the United States currently receive hemodialysis,
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and the costs of the treatment are paid principally by Medicare. Rates of reimbursement for hemodialysis providers have remained relatively constant over the past two decades and increased only 1.2 percent last year.
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The percentage of patients treated with dialysis in for-profit facilities has grown from 40 percent in 1982 to 68 percent in 1997.
1
,
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There is concern that with constraints on reimbursement and increasing privatization, dialysis providers are motivated to control costs, sometimes to the detriment of patient care.
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One way of reducing costs is to avoid the . . .