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Outbreak of JK diphtheroid infections associated with environmental contamination
Abstract:
The group JK diphtheroid organism is a multiply resistant opportunistic pathogen which infects immunocompromised patients sporadically. We describe the first reported outbreak of JK diphtheroid infections, in which four cases of bacteremia and one Hickman catheter site infection occurred during 4 weeks on a hematology ward. On this ward, JK diphtheroid was recovered from 17 of 39 patients, 10 of 17 30-ft3 (0.840-m3) air samples, surfaces in 9 of 13 patient rooms, and hands of 4 of 22 personnel. Previously identified risk factors for JK diphtheroid sepsis (male gender, broad-spectrum antibiotic therapy, granulocytopenia, and prolonged hospital stay) were present in infected patients but did not distinguish them from patients who were only colonized. Emphasis on aseptic practices was associated with termination of the outbreak and negative hand cultures from personnel, despite continued patient colonization and environmental contamination.
Insights
A multiply resistant bacterium, JK diphtheroid, caused an outbreak on a hematology ward. Strict aseptic practices halted the spread, even with ongoing patient and environmental contamination.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- The JK diphtheroid organism is an opportunistic pathogen known for multiply resistant infections, primarily affecting immunocompromised individuals.
- Sporadic cases of JK diphtheroid infections have been documented, but outbreaks in healthcare settings are less common.
Purpose of the Study:
- To report the first documented outbreak of JK diphtheroid infections on a hematology ward.
- To investigate the epidemiology, risk factors, and control measures associated with this outbreak.
Main Methods:
- Retrospective case review and surveillance on a hematology ward over a 4-week period.
- Environmental sampling (air, surfaces) and personnel hand cultures were performed.
- Analysis of patient demographics and clinical data, including known risk factors for JK diphtheroid sepsis.
Main Results:
- Four cases of bacteremia and one Hickman catheter site infection due to JK diphtheroid occurred.
- The organism was recovered from a significant proportion of patients (17/39), air samples (10/17), room surfaces (9/13), and healthcare personnel hands (4/22).
- Established risk factors were present in infected patients but did not differentiate them from colonized individuals.
Conclusions:
- Aseptic practices were crucial in controlling the outbreak, leading to negative hand cultures in personnel.
- Despite successful outbreak termination, persistent patient colonization and environmental contamination highlight the challenges in eradicating this pathogen.