"This outbreak illustrates the need for outpatient clinics to follow proper infection control guidelines and medication preparation practices to minimize the risk of infection for patients with weakened immune systems," said Isaac See, MD, lead author of the study. "A combination of careful descriptive epidemiology with attention to outlier cases, direct observations, and analytic studies were needed to support this investigation, which pointed to deficiencies in medication preparation practices as the cause of these unusual infections."
From September 2011-May 2012, 15 immunocompromised patients developed Tsukamurella bloodstream infections. All patients had received a diagnosis of malignancy, and had an indwelling central line, although central line types varied. A case-control study determined that the only risk factor for developing Tsukamurella infection was the receipt of saline flush, prepared by the clinic staff from large preservative-free bags of saline, from the clinic during September-October 2011.
Investigations by the West Virginia Bureau of Public Health (WVBPH) and the CDC found several lapses in infection control procedures relating to the care of long-term intravenous catheters and preparation of chemotherapy for patients at the clinic. These investigations also suggested that saline flush syringes were the likely source of infection.
Following the recommendations of WVBPH and CDC, the clinic instituted several changes to its infection prevention and control practices; including using pre-packaged manufactured saline flushes. After the clinic changed this practice, Tsukamurella bloodstream infections stopped occurring, further supporting the saline flush as the source of infection.
To help outpatient oncology facilities establish appropriate infection control strategies, the CDC developed a basic infection control plan tailored to these settings outlining key policies and procedures needed to meet minimal requirements for patient safety. These include the proper use and handling of injectable medications and correct procedures for assessing central lines. Outpatient oncology facilities without an existing plan are encouraged to use this document as a starting point.
Isaac See, Duc B. Nguyen, Somu Chatterjee, Thein Shwe, Melissa Scott, Sherif Ibrahim, Heather Moulton-Meissner, Steven McNulty, Judith Noble-Wang, Cindy Price, Kim Schramm, Danae Bixler, Alice Y. Guh. "Outbreak of Tsukamurella spp. Bloodstream Infections among Patients of an Oncology Clinic—West Virginia, 2011-2012." Infection Control and Hospital Epidemiology 35:3 (March 2014).
Published through a partnership between the Society for Healthcare Epidemiology of America and The University of Chicago Press, Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13 out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.
SHEA is a professional society representing more than 2,000 physicians and other healthcare professionals around the world with expertise in healthcare epidemiology and infection prevention and control. SHEA's mission is to prevent and control healthcare-associated infections and advance the field of healthcare epidemiology. The society leads this field by promoting science and research and providing high-quality education and training in epidemiologic methods and prevention strategies. SHEA upholds the value and critical contributions of healthcare epidemiology to improving patient care and healthcare worker safety in all healthcare settings. Visit SHEA online at http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.
Tamara Moore | EurekAlert!
UofL scientists identify critical pathway to improve muscle repair
01.12.2015 | University of Louisville
University of California Scientists Create Malaria-Blocking Mosquitoes
30.11.2015 | University of California, Irvine
Chemical weathering of rocks over geological time scales is an important control on the stability of the climate. This weathering is, in turn, highly dependent...
Before the fluid of the middle ear drains and sound waves penetrate for the first time, the inner ear cells of newborn rodents practice for their big debut. Researchers at Johns Hopkins report they have figured out the molecular chain of events that enables the cells to make “sounds” on their own, essentially “practicing” their ability to process sounds in the world around them.
The researchers, who describe their experiments in the Dec. 3 edition of the journal Cell, show how hair cells in the inner ear can be activated in the absence...
Planet Earth experienced a global climate shift in the late 1980s on an unprecedented scale, fuelled by anthropogenic warming and a volcanic eruption, according to new research published this week.
Scientists say that a major step change, or ‘regime shift’, in the Earth’s biophysical systems, from the upper atmosphere to the depths of the ocean and from...
The Fraunhofer Institute for Solar Energy Systems ISE has installed 70 photovoltaic modules on the outer façade of one of its lab buildings. The modules were...
Nerve cells cover their high energy demand with glucose and lactate. Scientists of the University of Zurich now provide new support for this. They show for the first time in the intact mouse brain evidence for an exchange of lactate between different brain cells. With this study they were able to confirm a 20-year old hypothesis.
In comparison to other organs, the human brain has the highest energy requirements. The supply of energy for nerve cells and the particular role of lactic acid...
01.12.2015 | Event News
30.11.2015 | Event News
25.11.2015 | Event News
01.12.2015 | Earth Sciences
01.12.2015 | Life Sciences
01.12.2015 | Earth Sciences