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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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