While contamination of sterile products with bacteria is an extremely rare event, health teams should be on the alert for any signs of infection, because it can lead to sepsis. 

Sepsis is a medical emergency and occurs when an infection triggers a chain reaction throughout the body, which can led to organ failure and even death. Signs for patients and carers to be aware of include a rapid heart rate, a weak pulse, fever, shivering, feeling very unwell, shortness of breath, confusion and disorientation, extreme pain or low urine output. If someone has any of these signs and has recently had an intravenous fluid drip or a wound cleaned, they should seek immediate medical advice.

The outbreak of infections in Queensland hospitals that are linked to contaminated sterile saline is particularly worrying as a sterile product should not contain any microbes. There are rigorous tests that need to be done to confirm that a product is indeed sterile (absence of any microbes) before any pharmaceutical product can be sold as sterile. Sterility is an absolute state, a bit like a pregnancy. You cannot be almost pregnant or just a bit pregnant. You're either pregnant or not. The same with a sterile product. It is either sterile (devoid of microbes) or it is not sterile. 

Products such as saline need to be sterile as it is used to dilute medications that will be injected directly into a patient’s bloodstream. This means that the medication (and the microbe) has bypassed many of our natural defences against disease causing bugs. Ralstonia picketti is an organism found in soil and is not particularly dangerous to most people. It will not make you ill if you are a normal healthy person that gets exposed to it through, for example, contaminated soil or water, or it may cause a mild infection if entering through broken skin in a normally healthy person. However, the infections can be much more severe for people that are immunocompromised such as premature babies, cystic fibrosis patients, dialysis patients and anyone that needs to stay in a hospital for prolonged time. In these cases, exposure can lead to serious infections and ultimately death.

At least the authorities were able to pinpoint the source of infection relatively quickly and could proceed with withdrawing all the potentially contaminated saline products from hospitals and healthcare centres. The investigation into how the contamination could occur in the saline is now ongoing and should help to prevent similar outbreaks in the future.