Infant's Death Linked to Dietary Supplement
Published: Nov 25, 2014
A contaminated dietary supplement is being linked to the death of a preterm infant from gastrointestinal mucormycosis.
In an advisory on the Health Alert Network, the CDC is telling clinicians to be aware of the possibility of the use of the product -- Solgar ABC Dophilus Powder -- when evaluating either preterm infants for necrotizing enterocolitis or infants who have signs or symptoms of gastrointestinal mucormycosis, including abdominal pain, abdominal distension, nausea, or vomiting.
If the patient consumed the product, the CDC advises considering a consultation with an infectious disease physician for an assessment that might include "aggressive" evaluation for a source of infection, including surgical exploration, and empiric treatment with antifungals active against mucormycete infections.
The product is a dietary supplement intended to contain three viable bacteria, Bifidobacterium lactis,Streptococcus thermophilus, and Lactobacillus rhamnosus. It is claimed to have "probiotic" properties and is marketed for infants and children by Solgar, of Leonia, N.J.
Such products are being used in preterm infants on the basis of a recent Cochrane review suggesting a benefit in cases of necrotizing enterocolitis, a possible complication in preterm infants, the CDC advisory said.
In this case, a preterm infant of 29 weeks gestation received lot 074 024 01R1 of the product for 4 days, starting at day one of life, in a Connecticut hospital.
The baby developed clinical signs and symptoms of necrotizing enterocolitis and surgical exploration revealed complete gastrointestinal ischemia from esophagus to rectum.
Surgeons resected a section of necrotic bowel but following surgery the baby developed several regions of vascular occlusion, something not usually associated with necrotizing enterocolitis. The infant died shortly afterward.
Tissue analysis of the necrotic bowel showed an angioinvasive fungal infection consistent with mucormycosis and staining of the tissue block was positive for several mucormycete fungal agents.
Sequencing the fungal DNA showed it to be Rhizopus oryzae, a known cause of mucormycosis, the advisory said. An investigation by the hospital found that unopened bottles of the lot were contaminated with mold, which was confirmed by the CDC to be R. oryzae.
The company has recalled lots 074024-01R1, 074024-01, and 074024-02 of the product, all with expiration dates of July 31, 2015. The product was distributed to 29 states, Puerto Rico, the U.K., and Israel.
The CDC is asking clinicians and public health officials to notify state or local health departments if they know of confirmed or suspected cases of infants with gastrointestinal mucormycosis or unexplained infant deaths within 30 days after ingesting Solgar ABC Dophilus Powder since Nov. 1.
Không có nhận xét nào:
Đăng nhận xét