Ultrasound gel as a source of hospital outbreaks: Indian experience and literature review.

Autor: Solaimalai D; Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India., Devanga Ragupathi NK; Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India., Ranjini K; Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India., Paul H; Hospital Infection Control Committee, Christian Medical College, Vellore, Tamil Nadu, India., Verghese VP; Department of Child Health; Hospital Infection Control Committee, Christian Medical College, Vellore, Tamil Nadu, India., Michael JS; Department of Clinical Microbiology; Hospital Infection Control Committee, Christian Medical College, Vellore, Tamil Nadu, India., Veeraraghavan B; Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India., James EJ; Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India.
Jazyk: angličtina
Zdroj: Indian journal of medical microbiology [Indian J Med Microbiol] 2019 Apr-Jun; Vol. 37 (2), pp. 263-267.
DOI: 10.4103/ijmm.IJMM_19_249
Abstrakt: Purpose: Hospital outbreaks are observed increasingly worldwide with various organisms from different sources such as contaminated ultrasound gel, intravenous (IV) fluids and IV medications. Among these, ultrasound gel is one of the most commonly reported sources for Burkholderia cepacia complex (Bcc) outbreaks. In this study, we describe our experience on investigation and the management of Bcc bacteraemia outbreak due to contaminated ultrasound gel from a tertiary care centre, South India.
Materials and Methods: Over a 10-day period in October 2016, seven children in our Paediatric intensive care unit (ICU) were found to have bacteraemia with Bcc isolated from their blood culture. Repeated isolation of the same organism with similar antimicrobial susceptibility pattern over a short incubation period from the same location, confirmed the outbreak. An active outbreak investigation, including environmental surveillance, was carried out to find the source and control the outbreak. Isolates were subjected to multi-locus sequence typing (MLST) and global eBURST (goeBURST) analysis.
Results: Environmental surveillance revealed contaminated ultrasound gel as the source of infection. MLST and goeBURST analysis confirmed that the outbreak was caused by a novel sequence type 1362 with the same clonal complex CC517. The outbreak was controlled by stringent infection control measures, withdrawal of contaminated ultrasound gel from regular usage and implementing the practice of using ultrasonogram (USG) probe cover for USG screening and guided procedures.
Conclusion: This report highlights the importance of early identification of an outbreak, prompt response of the ICU and infection control teams, sound environmental and epidemiological surveillance methods to identify the source and stringent infection control measures to control the outbreak. Contaminated ultrasound gel can be a potential source for healthcare-associated infection, which cannot be overlooked.
Competing Interests: None
Databáze: MEDLINE
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