Erwinia

THE ROLE OF NATIONWIDE NOSOCOMIAL INFECTION SURVEILLANCE IN DETECTING EPIDEMIC BACTEREMIA
DUE TO CONTAMINATED INTRAVENOUS FLUIDS

Since January, 1970, the Center for Disease Control (CDC) has coordinated surveillance of nosocomial infections in a
group of voluntarily cooperating hospitals In the United States. In 1970, this surveillance system failed to realize one of
its major goals: detection of a nationwide epidemic of septicemia caused by contaminated Intravenous products.
However, retrospective review of Infections reported to CDC revealed that the data received were sufficient for the
outbreak to have been recognized. Beginning in July, 1970, one month after the contaminated products were first
distributed and five months before the outbreak was actually detected, CDC data showed a persistent increase In the
Incidence of Enterobacter and
Erwinia (presently designated Enterobacter agglomerans) bacteremia. Furthermore,
monthly rates of cases of bacteremia caused by these organisms were higher in hospitals using the contaminated
intravenous products than for hospitals not using them. Failure to detect this outbreak at the time of its occurrence was
due to delays In data processing and Insufficiently sophisticated data analysis. Based on this experience, CDC has
modified the surveillance system to aid recognition of future outbreaks
American Journal of Epidemiology Vol. 108, No. 3: 207-213  (1970)

First Report of a Human Isolate of Erwinia persicinus

Erwinia persicinus was first described in 1990 after being isolated from a variety of fruits and vegetables,
including bananas, cucumbers, and tomatoes. In 1994, it was shown to be the causative agent of necrosis of
bean pods. We now report the first human isolate of E. persicinus. The strain was isolated from the urine of an
88-year-old woman who presented with a urinary tract infection. By the hydroxyapatite method, DNA from this
strain was shown to be 94.5% related at 60°C and 86% related at 75°C to the type strain of E. persicinus. The
biochemical profile of E. persicinus is most similar to those of Erwinia rhapontici, Pantoea agglomerans, and
Enterobacter species. It is negative in tests for lysine, arginine, ornithine, dulcitol, and urea. It is motile and
positive in tests for D-sorbitol and sucrose. It is susceptible to the expanded-spectrum cephalosporins,
aminoglycosides, and fluoroquinolones, but it is resistant to ampicillin, ticarcillin, and cefazolin.
JOURNAL OF CLINICAL MICROBIOLOGY, Jan. 1998, p. 248–250