Yingmei Liu1, Kun Liu2, Xiaomin Yu1, Binbin Li1, Bin Cao3. 1. Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang South Road, Chaoyang District, Beijing 100020, People's Republic of China; Beijing Institute of Respiratory Medicine, Beijing, People's Republic of China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation, Beijing, People's Republic of China. 2. Department of Infection Control, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China. 3. Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang South Road, Chaoyang District, Beijing 100020, People's Republic of China; Beijing Institute of Respiratory Medicine, Beijing, People's Republic of China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation, Beijing, People's Republic of China. Electronic address: caobin1999@gmail.com.
Abstract
OBJECTIVES: An outbreak of bacteremia caused by Pseudomonas spp (P. fulva and P. putida) was first identified in our hospital in the summer of 2010 and reoccurred in the following year. Based on the epidemiological data collected in these 2 years, we initiated an investigation on the source of the outbreak. The aim of this study was to report the results of the investigation, as well as the intervention strategies that resulted in successful control of the outbreak. METHODS: An infection control team was set up consisting of infectious disease specialists, microbiologists, infection control practitioners, and head nurses. The microbiology and medical records of case-patients with P. fulva or P. putida bloodstream infections were reviewed. Environmental samples and intravenous (IV) solutions from the wards and the pharmacy center were collected for culturing. The molecular characteristics of the bacterial isolates were studied by pulsed-field gel electrophoresis (PFGE). Strict infection control strategies were implemented. RESULTS: A total of 20 case-patients from five inpatient wards were identified during three summer seasons from 2010 to 2012. Nineteen of them recovered with proper antibiotics. Unfortunately one died from complications of heart failure. A total of 19 isolates of P. fulva and four of P. putida were identified, of which 20 were from blood, two from environmental surface samples from the hospital pharmacy, and one from an in-use compounded solution from a case-patient in the cardiology ward. Molecular analysis revealed that the P. fulva isolated from the in-use compounded solution (5% glucose solution containing insulin, isosorbide dinitrate, and potassium magnesium aspartate) and the environmental samples had the same PFGE type as the clinical isolates. CONCLUSIONS: The investigation identified that contaminated IV solution was the source of the P. fulva bacteremia, which prompted us to implement intensified control measures that resulted in successful control of the outbreak.
OBJECTIVES: An outbreak of bacteremia caused by Pseudomonas spp (P. fulva and P. putida) was first identified in our hospital in the summer of 2010 and reoccurred in the following year. Based on the epidemiological data collected in these 2 years, we initiated an investigation on the source of the outbreak. The aim of this study was to report the results of the investigation, as well as the intervention strategies that resulted in successful control of the outbreak. METHODS: An infection control team was set up consisting of infectious disease specialists, microbiologists, infection control practitioners, and head nurses. The microbiology and medical records of case-patients with P. fulva or P. putida bloodstream infections were reviewed. Environmental samples and intravenous (IV) solutions from the wards and the pharmacy center were collected for culturing. The molecular characteristics of the bacterial isolates were studied by pulsed-field gel electrophoresis (PFGE). Strict infection control strategies were implemented. RESULTS: A total of 20 case-patients from five inpatient wards were identified during three summer seasons from 2010 to 2012. Nineteen of them recovered with proper antibiotics. Unfortunately one died from complications of heart failure. A total of 19 isolates of P. fulva and four of P. putida were identified, of which 20 were from blood, two from environmental surface samples from the hospital pharmacy, and one from an in-use compounded solution from a case-patient in the cardiology ward. Molecular analysis revealed that the P. fulva isolated from the in-use compounded solution (5% glucose solution containing insulin, isosorbide dinitrate, and potassium magnesium aspartate) and the environmental samples had the same PFGE type as the clinical isolates. CONCLUSIONS: The investigation identified that contaminated IV solution was the source of the P. fulvabacteremia, which prompted us to implement intensified control measures that resulted in successful control of the outbreak.
Authors: Anthony Wong; Ana Carolina M Junqueira; Ankur Chaturvedi; Akira Uchida; Rikky W Purbojati; James N I Houghton; Caroline Chénard; Megan E Clare; Kavita K Kushwaha; Alexander Putra; Nicolas E Gaultier; Balakrishnan N V Premkrishnan; Vineeth Kodengil Vettath; Cassie E Heinle; Daniela I Drautz-Moses; Stephan C Schuster Journal: Microbiol Resour Announc Date: 2019-08-22