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An epidemic of Pseudomonas cepacia bacteraemia in Ramathibodi Hospital
Abstract:
An outbreak of P. cepacia bacteraemia involving 16 patients in Ramathibodi hospital from February to May 1988 was reported. The sources of infection were contaminated intravenous succinyl choline and metaraminol used by anaesthetists. Multiple dose preparations of the drugs were used. The drugs were prepared in bulk in an unhygienic room. Contamination occurred during or after the preparation. The outbreak was terminated by the improvement of hygiene in the anaesthetic preparation room, and the discontinuation of multiple-dose drugs.
Insights
A P. cepacia bacteraemia outbreak in 16 patients was linked to contaminated intravenous drugs. Improved hygiene and single-dose preparations stopped the spread.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- An outbreak of P. cepacia bacteraemia occurred at Ramathibodi Hospital.
- The outbreak involved 16 patients between February and May 1988.
Purpose of the Study:
- To identify the source and transmission route of the P. cepacia bacteraemia outbreak.
- To determine the interventions necessary to control and terminate the outbreak.
Main Methods:
- Retrospective analysis of patient cases and drug preparation procedures.
- Investigation of the anaesthetic preparation room environment and drug handling practices.
Main Results:
- The outbreak was traced to contaminated intravenous succinyl choline and metaraminol.
- Multiple-dose preparations of these drugs, prepared in bulk under unhygienic conditions, were the likely source of contamination.
- Contamination occurred during or after the drug preparation process.
Conclusions:
- Enhanced hygiene in the anaesthetic preparation room and discontinuation of multiple-dose drug preparations are crucial for outbreak control.
- Strict adherence to aseptic techniques during drug preparation is essential to prevent hospital-acquired infections.