Nosocomial outbreak of Pantoea agglomerans bacteraemia associated with contaminated anticoagulant citrate dextrose...

Area of Science:

• Microbiology
• Infectious Diseases
• Patient Safety

Background:

• Nosocomial infections pose significant threats to patient safety, particularly in immunocompromised individuals or those undergoing invasive procedures.
• Contamination of medical solutions can lead to severe bloodstream infections, complicating patient care and treatment.
• Plasmapheresis procedures, while beneficial, carry inherent risks that necessitate stringent aseptic techniques.

Purpose of the Study:

• To investigate an outbreak of bacteraemia linked to a specific medical solution.
• To identify the causative agent and its source.
• To determine the antimicrobial susceptibility profile of the identified pathogen.

Main Methods:

• Case identification and clinical data collection.
• Microbiological culture of blood samples and the implicated anticoagulant citrate-dextrose (ACD) solution.
• Bacterial identification using gyrB sequencing.
• Molecular typing of isolates by pulsed-field gel electrophoresis (PFGE).

Main Results:

• Eight cases of Pantoea agglomerans bacteraemia were identified over three weeks.
• P. agglomerans was isolated from six bags of in-house prepared ACD solution.
• PFGE confirmed that isolates from patients and ACD solution bags were identical.
• All identified P. agglomerans isolates exhibited susceptibility to common antibiotics.

Conclusions:

• In-house preparation of ACD solution was identified as the source of P. agglomerans bacteraemia.
• The outbreak underscores the importance of rigorous quality control in the preparation of medical solutions.
• Standard antibiotic susceptibility suggests effective treatment options were available, though source eradication was paramount.