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FDA - Multistate outbreak of fungal meningitis and other infections - Bacterial and/or fungal contaminants identified in additional NECC products; UPDATED

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  • FDA - Multistate outbreak of fungal meningitis and other infections - Bacterial and/or fungal contaminants identified in additional NECC products; UPDATED

    (NOTE: Format edited for clarity.)


    Multistate outbreak of fungal meningitis and other infections

    Update on NECC Products: Samples of betamethasone and cardioplegia solution test positive for bacterial contamination


    [11-01-2012] The U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) are reporting laboratory results from samples of two additional recalled NECC products – preservative free betamethasone and cardioplegia solution. Previously, the fungus Exserohilum rostratum was identified in NECC-supplied, preservative-free methylprednisolone acetate (MPA).

    The FDA and CDC laboratories have identified bacteria present in three separate lots (batches) of NECC-supplied preservative-free betamethasone, with each lot producing different culture results, and in a single lot of NECC cardioplegia solution.



    Product and Lot Number
    Betamethasone 08202012@141

    Microbial Identification:
    Paenibacillus pabuli/amolyticus, Bacillus idriensis, Bacillus flexus, Bacillus simplex, Lysinibacillus sp.



    Product and Lot Number:
    Betamethasone 07032012@22

    Microbial Identification:
    Bacillus niabensis, Bacillus circulans



    Product and Lot Number:
    Betamethasone 07302012@52

    Microbial Identification:

    Bacillus lentus, Bacillus circulans



    Product and Lot Number:
    Cardioplegia solution 09242012@55

    Microbial Identification:
    Bacillus halmapalus, Brevibacillus choshinensis


    The clinical significance of these results is not known. Both Bacillus idriensis and Bacillus circulans have been rarely reported as a cause of human disease. CDC continues to investigate reports of potential infections in patients receiving other NECC products. As of Nov. 1, CDC has not received reports of laboratory-confirmed cases of infection due to Bacillus or closely related organisms linked to betamethasone or cardioplegia solution from NECC.

    Fungal cultures for betamethasone and cardioplegia solution are pending and the presence of additional microbial organisms and/or fungus in these products cannot be ruled out at this time.

    Although final laboratory results on additional samples are still pending, the previous finding of fungal contamination of MPA and recent finding of bacterial contamination of betamethasone and cardioplegia solution reinforce the FDA’s concern about the lack of sterility in products produced at NECC’s compounding facility and serve to underscore that hospitals, clinics, and health care providers should not use any NECC-supplied products. All NECC products are subject to NECC’s recall announced on Oct. 6, 2012.

    As previously confirmed by the CDC and FDA, the fungus Exserohilum rostratum was identified from 2 different lots of NECC-supplied, preservative-free MPA (Lot #06292012@26 and Lot #08102012@51), which have been associated with the outbreak of fungal meningitis and other infections in patients. Testing on the third implicated lot of MPA (Lot #05212012@68), as well as other NECC products, is ongoing.

    Health care professionals and patients may call the FDA's Drug Information Line at 855-543-DRUG (3784) and press * to get the most recent information regarding the Ameridose recall and speak directly to a pharmacist.

    The FDA asks health care professionals and consumers to report any adverse reactions to the FDA's MedWatch Program by fax at 800-FDA-0178, by mail at MedWatch, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787, or on the MedWatch website at www.fda.gov/medwatch.
    Last edited by Catbird; November 1, 2012, 03:45 PM. Reason: fix format



    "What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon

    "The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston

  • #2
    Re: FDA - Multistate outbreak of fungal meningitis and other infections - 2 additional NECC products test positive for bacterial contamination

    The FDA website has been updated to include the following NEW information. (NOTE from CB: New information shown in red.)

    Updated excerpt from:

    Multistate outbreak of fungal meningitis and other infections


    Update on NECC Products: Samples of injectable betamethasone and cardioplegia solution test positive for bacterial contamination


    [11-02-12] *The chart is updated to include additional species of Bacillus bacteria.

    [11-01-2012] The U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) are reporting laboratory results from samples of two additional recalled NECC products ? preservative-free injectable betamethasone and cardioplegia solution. Previously, the fungus Exserohilum rostratum was identified in NECC-supplied, preservative-free methylprednisolone acetate (MPA).

    The FDA and CDC laboratories have identified bacteria present in three separate lots (batches) of NECC-supplied preservative-free injectable betamethasone, with each lot producing different culture results, and in a single lot of NECC cardioplegia solution.


    Product and Lot Number
    Betamethasone 6 mg/mL injectable ? 5 mL per vial 08202012@141

    Microbial Identification:
    Paenibacillus pabuli/amolyticus, Bacillus idriensis, Bacillus flexus, Bacillus simplex, Lysinibacillus sp., *Bacillus niacini



    Product and Lot Number:
    Betamethasone 6 mg/mL injectable ? 5 mL per vial 07032012@22

    Microbial Identification:
    Bacillus niabensis, Bacillus circulans



    Product and Lot Number:
    Betamethasone 12 mg/mL injectable ? 5 mL per vial 07302012@52

    Microbial Identification:
    Bacillus lentus, Bacillus circulans, Bacillus niabensis, Paenibacillus barengoltzii/timonensis



    Product and Lot Number:
    Cardioplegia solution 265.5 mL per bag 09242012@55

    Microbial Identification:
    Brevibacillus choshinensis, *Bacillus halmapalus/horikoshii, Brevibacillus choshinensis (NOTE from CB: Bacillus halmapalus has been removed and replaced with *Bacillus halmapalus/horikoshii)
    Last edited by Catbird; November 2, 2012, 07:35 PM. Reason: add link



    "What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon

    "The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston

    Comment


    • #3
      Re: FDA - Multistate outbreak of fungal meningitis and other infections - 2 additional NECC products test positive for bacterial contamination

      FDA update on NECC products. New information is marked with **.

      Excerpt from:

      Multistate outbreak of fungal meningitis and other infections


      Update on NECC Products: Samples of injectable betamethasone, injectable triamcinolone and cardioplegia solution test positive for microbial contamination

      [11-20-2012] **The chart is updated to include new culture results


      Medication
      Betamethasone 6 mg/mL injectable – 5 mL per vial

      Lot number
      08202012@141

      Microbial contamination
      Paenibacillus pabuli/amolyticus, Bacillus idriensis, Bacillus flexus, Bacillus simplex, Lysinibacillus sp., *Bacillus niacin, ** Koceria rosea, **Bacillus lentus



      Medication
      Betamethasone 6 mg/mL injectable – 5 mL per vial

      Lot number
      07032012@22

      Microbial contamination
      Bacillus niabensis, Bacillus circulans



      Medication
      Betamethasone 12 mg/mL injectable – 5 mL per vial

      Lot number
      07302012@52

      Microbial contamination
      Bacillus lentus, Bacillus circulans, *Bacillus niabensis, Paenibacillus barengoltzii/timonensis



      Medication
      **Betamethasone 6 mg/mL injectable – 5 mL per vial

      Lot number
      08202012@44

      Microbial contamination
      Bacillus lentus, Bacillus firmus, Bacillus pumilus



      Medication
      **Betamethasone 6 mg/mL injectable – 5 mL per vial

      Lot number
      08152012@84

      Microbial contamination
      Fungal growth – identification pending



      Medication
      **Triamcinolone 40 mg/mL injectable – 1 mL per vial

      Lot number
      06062012@6

      Microbial contamination
      Bacillus lentus, Bacillus circulans



      Medication
      **Triamcinolone 40 mg/mL injectable – 2 mL per vial

      Lot number
      08172012@60

      Microbial contamination
      Fungal growth – identification pending



      Medication
      **Triamcinolone 40 mg/mL injectable – 10 mL per vial

      Lot number
      08242012@2

      Microbial contamination
      Fungal growth – identification pending



      Medication
      Cardioplegia solution 265.5 mL per bag

      Lot number
      09242012@55

      Microbial contamination
      *Bacillus halmapalus/horikoshii, Brevibacillus choshinensis
      Last edited by Catbird; November 20, 2012, 08:42 PM. Reason: add link



      "What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon

      "The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston

      Comment


      • #4
        Re: FDA - Multistate outbreak of fungal meningitis and other infections - 2 additional NECC products test positive for bacterial contamination

        FDA: Multistate outbreak of fungal meningitis and other infections


        Update on NECC Products: Samples of injectable betamethasone, injectable triamcinolone and cardioplegia solution test positive for microbial contamination

        [11-30-2012] FDA and CDC have identified bacterial and/or fungal contamination in unopened vials of betamethasone, cardioplegia, and triamcinolone solutions distributed and recalled from NECC. These include bacteria known as Bacillus, and fungal species including Aspergillus tubingensis, Aspergillus fumigatus, Cladosporium species,and Penicillium species. Although rare, some of the identified Bacillus species can be human pathogens. Some of the fungal organisms identified, particularly Aspergillus fumigatus, are known to cause disease in humans. It is not known how product contamination with these organisms could affect patients clinically. See CDC?s Advice for Clinicians.


        CDC and FDA Laboratory-Confirmed Organisms from Product Samples


        Laboratory-Confirmed Organisms from Product Samples Associated with
        NECC Recalled Lots of Betamethasone, Cardioplegia, and Triamcinolone Solutions



        Medication- Betamethasone
        6 mg/mL injectable ?5 mL per vial

        Lot Number- 08202012@141

        Bacterial and Fungal Contamination- Paenibacillus pabuli/amolyticus, Bacillus idriensis, Bacillus flexus, Bacillus simplex, Lysinibacillus sp., Bacillus niacini, Kocuria rosea,
        Bacillus lentus


        Medication- Betamethasone
        6 mg/mL injectable ?5 mL per vial

        Lot Number- 07032012@22

        Bacterial and Fungal Contamination- Bacillus niabensis, Bacillus circulans


        Medication- Betamethasone
        12 mg/mL injectable ? 5 mL per vial

        Lot Number- 07302012@52

        Bacterial and Fungal Contamination- Bacillus lentus, Bacillus circulans, Bacillus niabensis, Paenibacillus barengoltzii/timonensis


        Medication- Betamethasone
        6mg/mL injectable ? 5 mL per vial

        Lot Number- 08202012@44

        Bacterial and Fungal Contamination- Bacillus lentus, Bacillus firmus, Bacillus pumilus


        Medication- Betamethasone
        6 mg/mL injectable ? 5 mL per vial

        Lot Number- 08152012@84

        Bacterial and Fungal Contamination- Penicillium sp., Cladosporium sp.


        Medication- Triamcinolone*
        40mg/mL injectable ? 1 mL per vial
        *Other identification of bacteria are pending for this product

        Lot Number- 06062012@6

        Bacterial and Fungal Contamination- Bacillus lentus, Bacillus circulans


        Medication- Triamcinolone
        40 mg/mL injectable ? 2 mL per vial

        Lot Number- 08172012@60

        Bacterial and Fungal Contamination- Aspergillus tubingensis, Penicillium sp.


        Medication- Triamcinolone
        40mg/mL injectable ? 10 mL per vial

        Lot Number- 08242012@2

        Bacterial and Fungal Contamination- Aspergillus fumigatus


        Medication- Cardioplegia solution
        265.5 mL per bag

        Lot Number- 09242012@55

        Bacterial and Fungal Contamination- Bacillus halmapalus/horikoshii, Brevibacillus choshinensis


        (NOTE from CB: Edited for formatting.)



        "What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon

        "The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston

        Comment


        • #5
          Re: FDA - Multistate outbreak of fungal meningitis and other infections - Bacterial and/or fungal contaminants identified in additional NECC products

          Update to the list of contaminants identified in NECC products. Newly identified contaminants are shown in red.





          Laboratory Testing and Results

          [12-12-2012] FDA and CDC have identified bacterial and/or fungal contamination in unopened vials of betamethasone, cardioplegia, and triamcinolone solutions distributed and recalled from NECC. These include bacteria known as Bacillus, and fungal species including Aspergillus tubingensis, Aspergillus fumigatus, Cladosporium species,and Penicillium species. Although rare, some of the identified Bacillus species can be human pathogens. Some of the fungal organisms identified, particularly Aspergillus fumigatus, are known to cause disease in humans. It is not known how product contamination with these organisms could affect patients clinically. See CDC?s Advice for Clinicians.


          CDC and FDA Laboratory-Confirmed Organisms from Product Samples

          Laboratory-Confirmed Organisms from Product Samples Associated with
          NECC Recalled Lots of Betamethasone, Cardioplegia, and Triamcinolone Solutions



          Medication- Betamethasone
          6 mg/mL injectable ?5 mL per vial

          Lot Number- 08202012@141

          Bacterial and Fungal Contamination- Paenibacillus pabuli/amolyticus, Bacillus idriensis, Bacillus flexus, Bacillus simplex, Lysinibacillus sp., Bacillus niacini, Kocuria rosea,
          Bacillus lentus


          Medication- Betamethasone
          6 mg/mL injectable ?5 mL per vial

          Lot Number- 07032012@22

          Bacterial and Fungal Contamination- Bacillus niabensis, Bacillus circulans


          Medication- Betamethasone
          12 mg/mL injectable ? 5 mL per vial

          Lot Number- 07302012@52

          Bacterial and Fungal Contamination- Bacillus lentus, Bacillus circulans, Bacillus niabensis, Paenibacillus barengoltzii/timonensis


          Medication- Betamethasone
          6mg/mL injectable ? 5 mL per vial

          Lot Number- 08202012@44

          Bacterial and Fungal Contamination- Bacillus lentus, Bacillus firmus, Bacillus pumilus


          Medication- Betamethasone
          6 mg/mL injectable ? 5 mL per vial

          Lot Number- 08152012@84

          Bacterial and Fungal Contamination- Penicillium sp., Cladosporium sp.


          Medication- Triamcinolone*
          40mg/mL injectable ? 1 mL per vial
          *Other identification of bacteria are pending for this product

          Lot Number- 06062012@6

          Bacterial and Fungal Contamination- Bacillus lentus, Bacillus circulans, Bacillus niabensis, Bacillus nealsonii, Bacillus subtilis group, Bacillus firmus


          Medication- Triamcinolone
          40 mg/mL injectable ? 2 mL per vial

          Lot Number- 08172012@60

          Bacterial and Fungal Contamination- Aspergillus tubingensis, Penicillium sp.


          Medication- Triamcinolone
          40mg/mL injectable ? 10 mL per vial

          Lot Number- 08242012@2

          Bacterial and Fungal Contamination- Aspergillus fumigatus


          Medication- Cardioplegia solution
          265.5 mL per bag

          Lot Number- 09242012@55

          Bacterial and Fungal Contamination- Bacillus halmapalus/horikoshii, Brevibacillus choshinensis



          "What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon

          "The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston

          Comment

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