A cluster of Mycobacterium wolinskyi surgical site infections at an academic medical center
| Autor: | Pritish K. Tosh, Jean E. Wentink, Avish Nagpal, Nancy L. Wengenack, Rodney L. Thompson, Elie F. Berbari, Dale A. Krageschmidt, Alan J. Wright, Kimberly C. Aronhalt |
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| Rok vydání: | 2014 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male medicine.medical_specialty Epidemiology Minnesota 030106 microbiology Disease cluster Disease Outbreaks Mycobacterium 03 medical and health sciences symbols.namesake 0302 clinical medicine Risk Factors Internal medicine medicine Infection control Humans Surgical Wound Infection Sampling (medicine) 030212 general & internal medicine Mycobacterium wolinskyi Cardiac Surgical Procedures Fisher's exact test Academic Medical Centers Infection Control Mycobacterium Infections biology business.industry Medical record Odds ratio Middle Aged biology.organism_classification Surgery Infectious Diseases Cardiothoracic surgery Case-Control Studies symbols Female business |
| Zdroj: | Infection control and hospital epidemiology. 35(9) |
| ISSN: | 1559-6834 0899-823X |
| Popis: | ObjectiveTo study a cluster ofMycobacterium wolinskyisurgical site infections (SSIs).DesignObservational and case-control study.SettingAcademic hospital.Patients.Subjects who developed SSIs withM. wolinskyifollowing cardiothoracic surgery.MethodsElectronic surveillance was performed for case finding as well as electronic medical record review of infected cases. Surgical procedures were observed. Medical chart review was conducted to identify risk factors. A case-control study was performed to identify risk factors for infection; Fisher exact or Kruskal-Wallis tests were used for comparisons of proportions and medians, respectively. Patient isolates were studied using pulsed-field gel electrophoresis (PFGE). Environmental microbiologic sampling was performed in operating rooms, including high-volume water sampling.ResultsSix definite cases ofM. wolinskyiSSI following cardiothoracic surgery were identified during the outbreak period (October 1, 2008–September 30, 2011). Having cardiac surgery in operating room A was significantly associated with infection (odds ratio, 40;P= .0027). Observational investigation revealed a cold-air blaster exclusive to operating room A as well a microbially contaminated, self-contained water source used in heart-lung machines. The isolates were indistinguishable or closely related by PFGE. No environmental samples were positive forM. wolinskyi.ConclusionsNo single point source was established, but 2 potential sources, including a cold-air blaster and a microbially contaminated, self-contained water system used in heart-lung machines for cardiothoracic operations, were identified. Both of these potential sources were removed, and subsequent active surveillance did not reveal any further cases ofM. wolinskyiSSI.Infect Control Hosp Epidemiol2014;35(9):1169-1175 |
| Databáze: | OpenAIRE |
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