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Nosocomial Ewingella americana bacteremia in an intensive care unit
Abstract:
Between Dec 8, 1982, and Jan 29, 1983, four cases of primary bacteremia with Ewingella americana occurred in the intensive care unit of a community hospital. The patients developed high fever and leukocytosis, which gradually resolved after institution of antibiotic therapy. All infected patients had undergone either cardiovascular or peripheral vascular surgery. Epidemiologic investigation revealed that the probable source for the Ewingella outbreak was contamination of the ice bath used to cool syringes for cardiac output determinations. The nosocomial outbreak was terminated by the introduction of a closed cardiac output injectate delivery system.
Insights
Four intensive care unit patients developed bacteremia from Ewingella americana after vascular surgery. Contaminated ice baths for cardiac output monitoring were the likely source. A closed system successfully terminated the nosocomial outbreak.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Nosocomial infections pose a significant threat in intensive care units (ICUs).
- Ewingella americana is an opportunistic pathogen that can cause serious infections.
- Vascular surgery patients are at increased risk for bloodstream infections.
Observation:
- Four cases of primary bacteremia caused by Ewingella americana occurred in an ICU between December 1982 and January 1983.
- All affected patients had recently undergone cardiovascular or peripheral vascular surgery.
- Patients presented with fever and leukocytosis, which resolved with antibiotic treatment.
Findings:
- Epidemiologic investigation identified a contaminated ice bath used for cardiac output determination syringes as the probable source of the outbreak.
- The outbreak was linked to a specific medical device and procedure.
- Introduction of a closed cardiac output injectate delivery system successfully halted the spread of infection.
Implications:
- Highlights the importance of meticulous infection control in ICUs.
- Underscores the need to scrutinize medical devices and procedures for potential contamination sources.
- Demonstrates the effectiveness of implementing closed systems to prevent nosocomial outbreaks.