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Investigation of an Outbreak of Gram-Negative Bacteremia Among Hematology-Oncology Outpatients

Published online by Cambridge University Press:  02 January 2015

Scott R. Penzak ,
Paul O. Gubbins ,
Shawna L. Stratton  and
Elias J. Anaissie
Scott R. Penzak
Affiliation:
Department of Pharmacy, Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
Paul O. Gubbins
Affiliation:
Department of Pharmacy, Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas
Shawna L. Stratton
Affiliation:
Arkansas Cancer Research Center, Division of Hematology and Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
Elias J. Anaissie*
Affiliation:
Arkansas Cancer Research Center, Division of Hematology and Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
*
Arkansas Cancer Research Center, Division of Hematology and Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205-7122
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Abstract

Objective:

To identify risk factors associated with an outbreak of gram-negative bacteremia (GNB).

Setting:

A university hospital.

Patients:

Hematology-oncology outpatients.

Design:

Retrospective case-control study.

Results:

Thirty-eight patients developed GNB; 13 patients experienced more than one episode, and eight blood cultures grew more than one gram-negative organism. The most frequently isolated organisms were Stenotrophomonas maltophilia, Klebsiella pneumoniae, Acinetobacter baumannii, and Acinetobacter johnsonii. When the GNB patients (cases) were compared with randomly selected hematology-oncology patients (controls), central venous catheter (CVC) self-care (71% vs 39%; P=.02), and duration of recent hospital stay (median, 15 vs 4 days; P=.01) were identified as risk factors. In a logistic regression model, duration of recent hospital stay was the only risk factor significantly associated with GNB (odds ratio, 1.05; 95% confidence interval, 1.01-1.08; P<.02).

Conclusions:

Hematology-oncology patients providing their own CVC care who have recently been hospitalized for more than 2 weeks may be at increased risk of GNB. CVCs should be protected from possible environmental contamination in hematology-oncology patients. Patients providing their own CVC care should undergo continued rigorous education regarding proper CVC care.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 9 , September 2000 , pp. 597 - 599
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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References

1. Uzun, O, Anaissie, EJ. Outpatient therapy for febrile neutropenia: who, when, and how? J Antimicrob Chemother 1999;43:317–320.CrossRefGoogle ScholarPubMed
2. Anaissie, E, Samonis, G, Kontoyiannis, D, Costerton, J, Sabharwal, U, Bodey, G, et al. Role of catheter colonization and infrequent hematogenous seeding in catheter-related infections. Eur J Clin Microbiol Infect Dis 1995;14:134–137.Google Scholar
3. Salzman, MB, Rubin, LG. Intravenous catheter-related infections. Adv Pediatr Infect Dis 1995;10:337–368.Google Scholar
4. Castagnola, E, Garaventa, A, Montinaro, E, Sarni, P, Manfredini, P, Calvi, A, et al. Sepsis related to a permanent central venous catheter in children with neoplastic disease: practical implications of a continuous surveillance of the etiology [in Italian]. Pediatr Med Chir 1996;18:511–513.Google Scholar
5. Rizzari, C, Palamone, G, Corbetta, A, Uderzo, G, Vigano, EF, Codecasa, G. Central venous catheter-related infections in pediatric hematology-oncology patients: role of home and hospital management. Pediatr Hematol Oncol 1992;9:115–123.Google Scholar
6. Chodoff, A, Pettis, AM, Schoonmaker, D, Shelly, MA. Polymicrobial gram-negative bacteremia associated with saline solution flush used with a needleless intravenous system. Am J Infect Control 1995;23:357–363.Google Scholar
7. Rutala, WA, Weber, DJ. Water as a reservoir of nosocomial pathogens. Infect Control Hosp Epidemiol 1997;18:609–616.CrossRefGoogle ScholarPubMed
8. Khardori, N, Elting, L, Wong, E, Schable, B, Bodey, GP. Nosocomial infections due to Xanthomonas maltophilia (Pseudomonas maltophilia) in patients with cancer. Rev Infect Dis 1990;12:997–1003.CrossRefGoogle ScholarPubMed
9. Beck-Sague, CM, Jarvis, WR, Brook, JH, Culver, DH, Potts, A, Gay, E, et al. Epidemic bacteremia due to Acinetobacter baumannii in five intensive care units. Am J Epidemiol 1990;132:723–733.CrossRefGoogle ScholarPubMed