Roper St. Francis Healthcare, East Cooper Regional Medical Center and the Ralph H. Johnson Veterans Affairs Medical Center said Wednesday they are contacting patients who received drugs made by the New England Compounding Center, the firm under investigation for a national outbreak of fungal meningitis linked to a tainted steroid.

Roper, East Cooper and the VA Medical Center said they did not purchase the suspect NECC steroid methylprednisolone acetate that is linked with more than 200 cases of fungal meningitis, including 15 deaths, in patients who received the drug by spinal injection.

Roper said it will contact 208 patients who received the pain medicine nalbuphine manufactured by NECC. East Cooper said it was compiling information on patients who may have received the NECC drug triamcinolone as well as “injectable opthalmic products,” and it would contact them within the week. It did not say how many patients may be affected.

The VA Medical Center already has contacted patients who received NECC products, none of which have been identified as definitely causing health problems, said Tonya Lobbestael, center spokeswoman.

The number of veterans contacted about the NECC drugs and the identities of those involved were not available Wednesday night, she said.

Roper and East Cooper health care systems noted that the NECC drugs that they used had not been linked with infection. They said the action was prompted by a new recommendation from the U.S. Food and Drug Administration.

The situation applies to patients who received the drugs after May 21, the FDA said.

Dr. Todd Shuman, director of quality for Roper, said the health care system used nalbuphine at its three hospitals.

“We don’t know that the medication has any risk at all,” he said.

In confirmed cases of fungal meningitis, the suspect steroid methylprednisolone acetate was given by spinal injection. Nalbuphine is injected into a muscle or vein, he said.

“It’s a totally different thing,” he said.

Roper St. Francis Healthcare includes Roper Hospital, Bon Secours St. Francis Hospital and Roper St. Francis Mount Pleasant Hospital.

East Cooper and Roper said that the action is necessary because the FDA has expanded the number of NECC drugs it is investigating. All of NECC’s hundreds of products were the subject of a recent nationwide recall, so they are no longer in use.

The Medical University of South Carolina and Trident Regional Medical Center said they did not purchase NECC products.

Intervene MD in Mount Pleasant and North Charleston has contacted 257 patients who received spinal injections of methylprednisolone acetate and 78 people who had the drug injected into a joint. The clinic is the only one reported so far in South Carolina to have received and used the possibly tainted steroid.

No cases of fungal meningitis have been reported in the state, but 12 people treated at Intervene MD have been referred for further evaluation.

The scope of the problem continued to grow on Wednesday as the Centers for Disease Control and Prevention reported 245 cases of fungal meningitis and 19 deaths in 15 states, up from Tuesday’s count of 233 cases and 15 deaths. Two cases of infection were also reported in patients who received injections of methylprednisolone acetate in an ankle.

The FDA estimates that 14,000 people could be at risk nationwide.

Meningitis symptoms include fever, headache, stiff neck, nausea, vomiting, sensitivity to light and altered mental status.

At its website, the FDA says the sterility of any injectable drug made by NECC is of significant concern, and out of an abundance of caution, patients who received the products should be alerted to the potential risk of infection.

On Oct. 4, the FDA advised health care providers to stop using any NECC products. It reported finding a fungal contaminant in unopened vials of methylprednisolone acetate at NECC.

On Tuesday, the state Department of Health and Environmental control issued an advisory based on FDA information that recommended follow-up for patients who received an NECC injectable product, including an opthalmic drug used in eye surgery and a cardioplegic solution used in heart surgery. The FDA considers patients who received NECC topical products at lower risk, DHEC said.