Informacja

Drogi użytkowniku, aplikacja do prawidłowego działania wymaga obsługi JavaScript. Proszę włącz obsługę JavaScript w Twojej przeglądarce.

Przeglądasz jako GOŚĆ
Tytuł pozycji:

2454. A Cluster of Gram-Negative Bloodstream Infections in Connecticut Hemodialysis Patients Associated with Contaminated Wall Boxes and Priming Buckets

Tytuł :
2454. A Cluster of Gram-Negative Bloodstream Infections in Connecticut Hemodialysis Patients Associated with Contaminated Wall Boxes and Priming Buckets
Autorzy :
Backman, Lauren
Dumigan, Diane G
Harizaj, Adora
Oleksiw, Marylee
Carusillo, Evelyn
Malo, Sue
Ransom, Acacia
Patel, Priti
Nguyen, Duc
Moulton-Meissner, Heather
Boyce, John M
Pokaż więcej
Temat :
Abstracts
Poster Abstracts
Źródło :
Open Forum Infectious Diseases
Wydawca :
Oxford University Press, 2019.
Rok publikacji :
2019
Oryginalny identyfikator :
pmc: PMC6809843
Język :
English
ISSN :
2328-8957
DOI :
10.1093/ofid/ofz360.2132
Background Patients requiring maintenance hemodialysis (HD) are at increased risk of bloodstream infections. We investigated a cluster of infections due to unusual Gram-negative bacilli that affected patients undergoing HD at an outpatient unit with 19 stations (Clinic A). Methods A case was defined as a HD patient at Clinic A with >1 blood or urine culture positive for Delftia acidovorans, Enterobacter absuriae, or Burkholderia cepacia during the period February 1 – April 30, 2018. An investigation included review of patient records, facility policies, practice observation, environmental cultures, and a 1:4 case–control study. Controls were patients without bloodstream infection (BSI) during the outbreak period. Results The cluster included 3 patients. Patient 1 had BSI due to D. acidovorans (2/08), E. absuriae (3/15) and B. cepacia (3/17). Patient 2 had BSI due to D. acidovorans (3/17 and 3/27) and S. maltophilia (4/5). Patient 3 had a urine culture positive for D. acidovorans and S. maltophilia (4/2). The case–control study showed that cases had been dialyzed more often than controls on the third shift (P < 0.0001) and at station 2 (P < 0.0001), where subsequently a wall box spent dialysate drain connection swab culture yielded D. acidovorans. E. absuriae was recovered from wall boxes and spent dialysate drain connection at two stations and from used prime buckets from two stations; one wall box culture grew S. maltophilia. D. acidovorans and E. absuriae patient isolates were not available for genomic analysis. Observations revealed that waste water was leaking onto the floor from several wall boxes, and that priming buckets were often rinsed with tap water after being disinfected with 1:100 bleach solution and not allowed to dry before reuse. Multiple deficiencies in hand hygiene and station disinfection were observed. No deficiencies in water treatment practices were identified. Multiple water cultures obtained in August were negative for the observed pathogens. Conclusion A cluster of unusual Gram-negative infections in outpatient HD patients was most likely due to exposures to contaminated wall boxes or priming buckets; poor hand hygiene and station disinfection can contribute to transmission to patients. Disclosures All authors: No reported disclosures.
Zaloguj się, aby uzyskać dostęp do pełnego tekstu.

Ta witryna wykorzystuje pliki cookies do przechowywania informacji na Twoim komputerze. Pliki cookies stosujemy w celu świadczenia usług na najwyższym poziomie, w tym w sposób dostosowany do indywidualnych potrzeb. Korzystanie z witryny bez zmiany ustawień dotyczących cookies oznacza, że będą one zamieszczane w Twoim komputerze. W każdym momencie możesz dokonać zmiany ustawień dotyczących cookies