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Outbreak of Pseudomonas fluorescens bloodstream infection in a coronary care unit

N Benito1, B Mirelis, M Luz Gálvez

  • 1Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. nbenito@santpau.cat

The Journal of Hospital Infection
|October 30, 2012
PubMed

Insights

A Pseudomonas fluorescens outbreak in a coronary care unit was linked to an ice bath used for cardiac output measurements. This highlights a new source for pseudobacteraemia and bloodstream infections (BSI).

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Pseudomonas fluorescens (P. fluorescens) bloodstream infections (BSI) are uncommon.
  • Previous outbreaks have been linked to contaminated medical products.
  • A novel source of P. fluorescens infection requires identification.

Purpose of the Study:

  • To report a third outbreak of P. fluorescens BSI in two decades.
  • To identify the source of infection in six patients in a coronary care unit.
  • To alert clinicians to potential contamination risks.

Main Methods:

  • Case identification in a coronary care unit.
  • Microbiological investigation to identify the causative agent.
  • Environmental sampling to pinpoint the source of contamination.

Main Results:

  • Six patients in the coronary care unit developed P. fluorescens infection.
  • The outbreak was traced to an ice bath used for cardiac output determinations.
  • This represents a previously unreported source for P. fluorescens pseudobacteraemia.

Conclusions:

  • Ice baths used for cardiac output measurements can be a source of P. fluorescens contamination.
  • Clinicians should consider contamination of infusates, lock solutions, or catheter flush when P. fluorescens is isolated from blood cultures.
  • Enhanced vigilance and infection control measures are necessary to prevent similar outbreaks.

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