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Pseudomonas aeruginosa orbital cellulitis in four neutropenic patients
M C Atkins1, G A Harrison, G S Lucas
1Department of Medical Microbiology, University Hospital of Wales, Heath Park, Cardiff.
Abstract:
Four neutropenic patients on a haematology ward developed orbital cellulitis due to different strains of Pseudomonas aeruginosa over a 7-month period. Investigation of patients and the ward environment revealed two P. aeruginosa isolates indistinguishable from the infecting strains in a plastic washing bowl and a sink in a single cubicle respectively. These items were unlikely to have been the sources of the infecting strains but were a potential cross infection hazard. Treatment of orbital cellulitis is discussed briefly.
Insights
Pseudomonas aeruginosa caused orbital cellulitis in four neutropenic patients. Environmental sampling found the bacteria in a washing bowl and sink, highlighting potential cross-infection risks in hematology wards.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Bacteriology
Background:
- Neutropenic patients are highly susceptible to infections.
- Orbital cellulitis is a serious infection that can lead to severe complications.
- Pseudomonas aeruginosa is an opportunistic pathogen frequently found in healthcare settings.
Purpose of the Study:
- To report a cluster of orbital cellulitis cases caused by Pseudomonas aeruginosa in neutropenic patients.
- To investigate potential sources of infection within the hospital environment.
- To assess the risk of cross-infection from environmental reservoirs.
Main Methods:
- Case series of four neutropenic patients with orbital cellulitis.
- Microbiological investigation of patient isolates and environmental samples.
- Strain typing of Pseudomonas aeruginosa isolates to compare patient and environmental strains.
Main Results:
- Four distinct strains of Pseudomonas aeruginosa were identified as the causative agents.
- Identical Pseudomonas aeruginosa strains were isolated from a plastic washing bowl and a sink in a patient cubicle.
- Environmental isolates were not definitively identified as the source but posed a cross-infection risk.
Conclusions:
- Pseudomonas aeruginosa poses a significant threat to neutropenic patients, potentially causing severe infections like orbital cellulitis.
- Environmental contamination with Pseudomonas aeruginosa in healthcare settings represents a cross-infection hazard.
- Vigilance in environmental hygiene and infection control is crucial in hematology wards to protect vulnerable patients.