Presumed pseudobacteremia outbreak resulting from contamination of proportional disinfectant dispenser

Area of Science:

• Medical Microbiology
• Infectious Disease Epidemiology
• Hospital Infection Control

Background:

• Hematological patients are susceptible to infections due to neutropenia.
• Nosocomial infections pose a significant threat in healthcare settings.
• Aerobic gram-negative bacilli are common opportunistic pathogens.

Purpose of the Study:

• To investigate an outbreak of aerobic gram-negative bacilli infections in hematological patients.
• To identify the source and transmission route of the infections.
• To implement control measures to prevent future outbreaks.

Main Methods:

• Microbiological analysis of clinical isolates and environmental samples.
• Epidemiological investigation including patient data and staff interviews.
• Genotyping of bacterial strains to determine relatedness.
• Identification of the disinfectant and dispensing apparatus as the source.

Main Results:

• Nineteen neutropenic patients developed infections with Pseudomonas fluorescens, Achromobacter xylosoxidans, Comamonas testosteroni, and Stenotrophomonas maltophilia.
• The same bacteria were isolated from the disinfectant dispensing apparatus and environmental samples.
• Genotyping confirmed the link between clinical strains and environmental isolates.
• Staff disinfecting blood-culture bottles with contaminated disinfectant was the primary contamination route.

Conclusions:

• Contaminated disinfectant used for blood-culture bottles caused a nosocomial outbreak.
• Faulty maintenance of the disinfectant apparatus contributed to environmental contamination.
• Strict adherence to disinfection protocols and equipment maintenance is crucial for infection control.