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Outbreak of wound infections following outpatient podiatric surgery due to contaminated bone drills
Abstract:
An outbreak of podiatric infections due to an uncommon strain of Proteus mirabilis occurred following outpatient podiatric surgery. An evaluation of the operating room environment failed to reveal the strain of P. mirabilis from any site other than three bone drills. Thus the drills served as the reservoir for the organism that was subsequently inoculated onto the hands of the surgeon or directly to a patient during bone drilling. The gas sterilization procedure that was used to sterilize the drills was found deficient. No additional cases of P. mirabilis infection have been observed since the elimination of the contaminated drills.
Insights
An uncommon Proteus mirabilis strain caused podiatric infections after surgery. Contaminated bone drills, not properly sterilized, were the source, leading to surgical site infections. Eliminating the drills stopped the outbreak.
Area of Science:
- Microbiology
- Infectious Diseases
- Surgical Infection Prevention
Background:
- An outbreak of podiatric infections was identified.
- The causative agent was an uncommon strain of Proteus mirabilis.
- Infections occurred after outpatient podiatric surgery.
Purpose of the Study:
- To investigate the source and transmission route of the Proteus mirabilis outbreak.
- To identify the reservoir of the uncommon bacterial strain.
- To evaluate the effectiveness of the sterilization procedures.
Main Methods:
- Environmental evaluation of the operating room.
- Microbiological investigation of potential reservoirs, including surgical instruments.
- Review of sterilization procedures used for surgical equipment.
Main Results:
- Proteus mirabilis was isolated from three bone drills, identifying them as the reservoir.
- The gas sterilization procedure for the drills was found to be deficient.
- Elimination of the contaminated drills led to the cessation of new infections.
Conclusions:
- Deficient gas sterilization of bone drills was the cause of the Proteus mirabilis outbreak.
- Surgical instruments can act as reservoirs for pathogens, leading to surgical site infections.
- Proper sterilization protocols are critical for preventing healthcare-associated infections in podiatric surgery.