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Outbreak of urinary tract infections by Salmonella spp. after cystoscopic manipulation
A Jimeno1, M M Alcalde1, M Ortiz2
1Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, Hospital Universitario Santa Lucía, Cartagena, España.
Introduction:
Cystoscopes are used for diagnostic and therapeutic purposes and can be vehicles for transmitting healthcare-associated infections. Performing urine cultures before manipulation or administering prophylaxis is determined by the presence or not of risk factors for urinary tract infection.
Methods:
Between October and November 2014, we identified an unusual aggregation of Salmonella spp. isolates in urine cultures at the University Hospital Santa Lucía of Cartagena (Murcia). An epidemiological investigation was conducted to assess the possible relationship between the cases.
Results:
Four patients had a urinary tract infection by Salmonella spp. within a short period, which suggests the presence of an outbreak. All of the patients had undergone cystoscopy. The index case had a urinary colonisation by Salmonella spp. prior to the procedure, and none of the reported cases had received prophylaxis. The environmental control cultures and the involved material cultures resulted negative. Intensification of the cystoscope cleaning and disinfection protocol achieved eradication of the outbreak.
Conclusion:
This is the first reported outbreak of Salmonella spp. related to the use of cystoscopes. The indication for a urine culture should be carefully assessed before conducting invasive urological procedures, as should the need for antibiotic prophylaxis, for patients with risk factors for severe infection. Strict control in the cleaning and disinfection of endoscopy material can prevent the transmission of infections related to this type of procedure.
Insights
A Salmonella outbreak linked to cystoscopes highlights the need for careful urine culture and prophylaxis decisions. Enhanced cleaning protocols for endoscopic equipment are crucial to prevent healthcare-associated infections.
Area of Science:
- Infectious Disease Epidemiology
- Healthcare-Associated Infections
- Urology
Background:
- Cystoscopes, used in urological procedures, can transmit healthcare-associated infections.
- Urine cultures and antibiotic prophylaxis decisions are guided by urinary tract infection risk factors.
Purpose of the Study:
- To investigate an unusual aggregation of Salmonella spp. in urine cultures.
- To assess the potential link between cystoscopy procedures and Salmonella urinary tract infections.
Main Methods:
- Epidemiological investigation of Salmonella spp. isolates in urine cultures.
- Analysis of patient history, including cystoscopy procedures and prophylaxis.
- Environmental and material cultures to identify sources of contamination.
Main Results:
- An outbreak of four Salmonella spp. urinary tract infections occurred in patients who underwent cystoscopy.
- The index case had pre-existing Salmonella colonization; no patients received prophylaxis.
- Intensified cystoscope cleaning and disinfection protocols successfully eradicated the outbreak.
Conclusions:
- This is the first reported outbreak of Salmonella spp. associated with cystoscope use.
- Careful assessment of urine culture indications and antibiotic prophylaxis is necessary for patients undergoing urological procedures.
- Strict adherence to cleaning and disinfection protocols for endoscopic equipment is vital to prevent infection transmission.
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01:17Urinary Tract Infection IV: Nursing Management
01:26Urine Studies II: Urine Culture and Sensitivity Test