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Bacillus Species Pseudomeningitis

Published online by Cambridge University Press:  21 June 2016

Ludwig A. Lettau*
Affiliation:
Infection Control Program, Greenville Memorial Medical Center, Greenville, South Carolina
Dean Benjamin
Affiliation:
Department of Microbiology, Greenville Memorial Medical Center, Greenville, South Carolina
H. Furman Cantrell
Affiliation:
Department of Microbiology, Greenville Memorial Medical Center, Greenville, South Carolina
David W. Potts
Affiliation:
Infection Control Program, Greenville Memorial Medical Center, Greenville, South Carolina
J. Michael Boggs
Affiliation:
Infection Control Program, Greenville Memorial Medical Center, Greenville, South Carolina
*
Greenville Memorial Medical Center, 701 Grove Road, Greenville, South Carolina 29605

Abstract

A cluster of cerebrospinal fluid Gram's stains showing gram-positive bacilli and of cerebrospinal fluid cultures growing Bacillus species in a large community teaching hospital prompted an epidemiologic and microbiologic investigation. Pseudomeningitis was suspected and confirmed when cultures of uninoculated commercial trypticase soy broth with 5% Fildes enrichment grew Bacillus species. Secondary contamination of the pipettes used for inoculation accounted for the positive cerebrospinal fluid Gram's stains. The costs of this pseudo-outbreak included unnecessary antibiotic therapy, lumbar punctures, and hospitalization. Such adverse effects can be minimized by increased physician awareness of pseudoinfections and by prompt investigation of such occurrences.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

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References

1. Weinstein, RA. Stamm, WE: Pseudoepidemics in hospital. Lancet 1977; 2:862864.CrossRefGoogle ScholarPubMed
2. Maki, DG: Through a glass darkly: Nosocomial pseudoepidemics and pseudobacteremias. Arch Intern Med 1980; 140:2028.CrossRefGoogle ScholarPubMed
3. Musher, DM, Schell, RF: False-positive gram stains of cerebrospinal fluid. Ann Intern Med 1973; 79:603604.CrossRefGoogle ScholarPubMed
4. Weinstein, RA, Bauer, FW, Hoffman, RD, et al: Factitious meningitis: Diagnostic error due to nonviable bacteria in commercial lumbar puncture trays. JAMA 1975; 233:878879.CrossRefGoogle ScholarPubMed
5. Ericsson, CD, Carmichael, M, Pickering, LK, et al: Erroneous diagnosis of meningitis due to false-positive gram stains. South Med J 1978; 71:15241525.CrossRefGoogle ScholarPubMed
6. Jovner, RW, Idriss, ZH, Wilfert, CM: Misinterpretation of cerebrospinal fluid gram stain. Pediatrics 1974; 51:300362.Google Scholar
7. Hoke, CH. Batt, JM. Mirrett, S. et al: False-positive gram-stained smears. JAMA 1979; 241:478480.CrossRefGoogle ScholarPubMed
8. Centers for Disease Control: False-positive gram stain due to nonviable organisms in sterile commercial transport medium. MMWR 1978: 27:23.Google Scholar
9. Walsh, DM. Eberiel, DT: Pseudomonas cepacia isolated from crystal violet solution in a hospital laboratory. J Clin Microbiol 1986; 23:962.CrossRefGoogle Scholar
10. Harris, AA. Pottage, JC. Fliegelman, R, et al: A pseudoepidemic due to Salmonella typhimurium . Diagn Microbiol Infect Dis 1983; 1:335337.CrossRefGoogle ScholarPubMed
11. Graham, DR, Anderson, RL, Ariel, FE., et al: Epidemic nosocomial meningitis due to Citrobacter diversus in neonates. J Infect Dis 1981: 144:203209.CrossRefGoogle ScholarPubMed
12. Goossens, H. Henocque, G, Kremp, L, et al: Nosocomial outbreak of Campylobacter jejuni meningitis in newborn infants. Lancet 1980; 2:146149.Google Scholar
13. Crowley, MM, Shannon, R. Spivack, M, et al: Pseudobacteremia due to intrinsic contamination of blood culture media Bacillus species (abstract). Am J Infect Control 1983; 11:150.Google Scholar
14. Noble, RC. Reeves, SA: Bacillus species pseudosepsis caused by contaminated commercial blood culture media. JAMA 1971; 230:10021004.CrossRefGoogle Scholar
15. MacDonald, N: Investigation of an outbreak of pseudobacteremia attributed to Bacillus species in a general hospital. Abstracts, 82nd Annual Meeting of the American Society for Microbiology, Atlanta, March 7-12, 1982, p 83.Google Scholar
16. Berger, SA: Pseudobacteremia due to contaminated alcohol swabs. J Clin Microbiol 1983; 18:974975.CrossRefGoogle ScholarPubMed
17. Gurevich, I. Tafuro, P. Krystofiak, S. et al: Three clusters of Bacillus pseudobacteremia related to a radiometric blood culture analyzer. Infect Control 1984; 5:7174.CrossRefGoogle ScholarPubMed
18. Goldstein, B, Abrutyn, E: Pseudo-outbreak of Bacillus species: Related to fibreoptic bronchoscope. J Hosp Infect 1985; 6:194200.CrossRefGoogle Scholar
19. Tuazon, CU, Murray, HW. Levy, C, et al: Serious infectious from Bacillus sp. JAMA 1979; 241:11371140.CrossRefGoogle Scholar
20. Cotton, DJ, Gill, VJ, Marshall, DJ, et al: Clinical features and therapeutic interventions in 17 cases of Bacillus bacteremia in an immunosuppressed patient population. J Clin Microbiol 1987; 25:672674.CrossRefGoogle Scholar