Outbreak of Arcanobacterium haemolyticum in chronic wounds in The Netherlands.

Autor: Bruins MJ; Isala, Laboratory of Clinical Microbiology and Infectious Diseases, Zwolle, The Netherlands. Electronic address: m.j.bruins@isala.nl., de Vries-van Rossum SV; Isala, Department of Infection Prevention, Zwolle, The Netherlands., Huiskes-Roerink R; Isala, Department of Infection Prevention, Zwolle, The Netherlands., Wallinga JA; Isala, Laboratory of Clinical Microbiology and Infectious Diseases, Zwolle, The Netherlands., Waindrich M; Isala, Department of Surgery, Zwolle, The Netherlands., Creemers K; QualityZorg, Nieuw-Vennep, The Netherlands., Oskam J; Isala, Department of Surgery, Zwolle, The Netherlands., Ruijs GJHM; Isala, Laboratory of Clinical Microbiology and Infectious Diseases, Zwolle, The Netherlands., Debast SB; Isala, Laboratory of Clinical Microbiology and Infectious Diseases, Zwolle, The Netherlands., Wagenvoort GHJ; Isala, Laboratory of Clinical Microbiology and Infectious Diseases, Zwolle, The Netherlands.
Jazyk: angličtina
Zdroj: The Journal of hospital infection [J Hosp Infect] 2020 Aug; Vol. 105 (4), pp. 691-697. Date of Electronic Publication: 2020 May 14.
DOI: 10.1016/j.jhin.2020.05.012
Abstrakt: Introduction: Aging and comorbidities such as diabetes and vascular problems contribute to the increasing occurrence of chronic wounds. From the beginning of 2016, a marked increase in Arcanobacterium haemolyticum (ARH) in chronic wound cultures was noted among patients visiting a wound expertise centre in The Netherlands.
Aim: To report the outbreak investigation of ARH cultured from chronic wounds and describe the implemented infection prevention measures.
Methods: In total, 50 ARH isolates were sent to a reference laboratory for molecular typing. Samples for bacterial culture and ARH polymerase chain reaction were taken from care workers, the environment and items used for wound care. Infection prevention measures were implemented in a bundled approach, involving education, better aseptic wound care conditions and hygienic precautions. Before and after the implementation of infection prevention measures, two screening rounds of ARH testing were performed among all patients receiving home care.
Results: ARH isolates from wound care patients were found to be identical by core genome multi-locus sequence typing. No definite outbreak source could be determined by culture. However, three pairs of forceps, used by two nurses on multiple patients, were found to be ARH positive by polymerase chain reaction. In the two screening rounds before and after the implementation of infection prevention measures, the proportion of ARH-positive patients decreased significantly from 20% (20/99) to 3% (3/104). Subsequently, no new cases occurred.
Conclusion: This first ARH outbreak was likely caused by re-using contaminated instruments. Through the implementation of improved infection prevention measures and re-education of all employees involved, the outbreak was controlled. With the current trend of care transition, infection control must be a major concern.
(Copyright © 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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