Longitudinal nosocomial outbreak of Pseudomonas fluorescens bloodstream infection of 2 years' duration in a coronary care unit

Publication date: Available online 21 June 2017
Source:American Journal of Infection Control
Author(s): Yuichiro Oba, Takahiro Nakajima, Chiyo Ogida, Miyuki Kawanami, Mamoru Fujiwara, Ikuko Matsumura
BackgroundOutbreaks of bloodstream infections (BSI) of nonfermenting bacteria are a critical issue and often associated with hospital environments. We experienced a long-lasting outbreak of Pseudomonas fluorescens BSI limited to a coronary care unit (CCU).MethodsWe conducted a retrospective epidemiologic investigation and a case-control study for Pseudomonas fluorescens BSI from April 2011-July 2014. Environmental sample culture was conducted to detect the specific environmental source of transmission.ResultsHospital-wide microbiology data from the term identified 13 case patients with P fluorescens BSI and 32 control patients with BSI due to organisms other than P fluorescens in the CCU. The case-control study revealed that the case group had significantly higher odds of exposure to only cardiac output (CO) measurement with thermodilution method (odds ratio, 22.0; 95% confidence interval, 2.4-202.3). The organism was identified only from an ice bath used for CO measurement. The susceptibility patterns were identical among all strains derived from the cases and the environment.ConclusionsThe nosocomial outbreak of P fluorescens BSI in our CCU over 2 years was associated with a contaminated ice bath used for CO measurement within the unit. Detection and elimination of the specific source was essential to stop the outbreak.



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