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Bacillus species pseudomeningitis
L A Lettau1, D Benjamin, H F Cantrell
1Infection Control Program, Greenville Memorial Medical Center, South Carolina 29605.
Infection Control and Hospital Epidemiology
|September 1, 1988
Summary
Contaminated lab supplies caused a false meningitis outbreak, leading to unnecessary treatments. Prompt investigation and physician awareness can prevent such costly pseudoinfections.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- A rise in positive cerebrospinal fluid (CSF) Gram's stains and cultures for Bacillus species was observed.
- This prompted an investigation into a potential outbreak of bacterial meningitis.
Purpose of the Study:
- To investigate the cause of a cluster of positive CSF Gram's stains and cultures.
- To identify the source of Bacillus species contamination and determine if it represented a true outbreak or pseudomeningitis.
Main Methods:
- Epidemiologic and microbiologic investigation was conducted.
- Cultures of uninoculated commercial trypticase soy broth with Fildes enrichment were performed.
- The source of contamination for CSF Gram's stains was identified.
Main Results:
- The investigation confirmed pseudomeningitis, not a true outbreak.
- Bacillus species were found to contaminate uninoculated laboratory broth.
- Secondary contamination of pipettes used for CSF inoculation was identified as the source of positive Gram's stains.
Conclusions:
- The observed cases were due to laboratory contamination, not actual meningitis.
- Pseudoinfections can lead to unnecessary medical interventions, including antibiotics and hospitalizations.
- Increased physician awareness and prompt investigation are crucial for minimizing the impact of pseudoinfections.