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Pseudomonas fluorescens pseudobacteraemia: a cautionary lesson
J Smith1, C Ashhurst-Smith, R Norton
1Department of Paediatrics, Townsville General Hospital, Townsville, Queensland, Australia.
Insights
A Pseudomonas fluorescens outbreak in children was traced to contaminated blood collection tubes. Improved blood culture techniques and staff education stopped the pseudobacteraemia, preventing unnecessary treatments.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Paediatrics
Background:
- Pseudobacteraemia, often caused by skin contaminants, can lead to unnecessary antibiotic use in children.
- Identifying the source of pseudobacteraemia is crucial to prevent patient harm and optimize clinical management.
Purpose of the Study:
- To investigate an outbreak of pseudobacteraemia caused by Pseudomonas fluorescens in a paediatric population.
- To determine the source of the outbreak and its impact on patient care.
- To implement measures to control and prevent future occurrences.
Main Methods:
- A retrospective clinical and microbiological investigation was conducted.
- Investigated a cluster of 38 pseudobacteraemias over 10 months.
- Identified contaminated lithium heparin tubes as the source of Pseudomonas fluorescens.
Main Results:
- Contaminated lithium heparin tubes, filled before blood culture bottles, were identified as the source.
- Positive blood cultures led to altered clinical management in 18 paediatric cases.
- A staff education program was implemented, leading to the cessation of the outbreak.
Conclusions:
- Pseudobacteraemias are a significant cause of potentially inappropriate therapy in febrile children.
- Meticulous attention to blood culture collection procedures is essential to minimize contamination.
- Healthcare staff must be educated on potential contamination sources during blood culture collection.
Objectives:
To describe an outbreak of pseudobacteraemia caused by Pseudomonas fluorescens in a paediatric population. To document and highlight the effect this outbreak had on clinical management and the steps taken to determine the source.
Methods:
A clinical and microbiological investigation was carried out into a cluster of 38 pseudobacteraemias caused by Pseudomonas fluorescens in paediatric patients over a 10 month period.
Results:
The source of the outbreak of pseudobacteraemia was found to be contaminated lithium heparin tubes, which were being filled prior to the filling of the blood culture bottle. Cultures of the same tubes yielded Pseudomonas fluorescens. As a result of the initial positive blood cultures, clinical management was altered in 18 cases. A staff education programme was instituted and eventually resulted in a cessation of the pseudobacteraemia.
Conclusions:
Pseudobacteraemias are a major cause of potentially inappropriate therapy in febrile children. Attention to detail in the collection of blood cultures can help reduce this outcome. Staff involved in the collection of blood cultures need to be aware of this potential source of contamination.