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Epidemic Bloodstream Infections Associated with Pressure Transducers: A Persistent Problem

Published online by Cambridge University Press:  21 June 2016

Consuelo M. Beck-Sague  and
William R. Jarvis
Consuelo M. Beck-Sague*
Affiliation:
Hospital Infectious Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
William R. Jarvis
Affiliation:
Hospital Infectious Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
*
Hospital Infections Program, Center for Infectious Diseases, Building 1-5044, Centers for Disease Control, Atlanta, GA 30333
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Abstract

Twenty-four outbreaks of nosocomial bloodstream infection (BSI) were investigated by the Centers for Disease Control from Jan 1, 1977 to Dec 31, 1987. Intravascular pressure monitoring devices (transducers) were the most commonly identified source of bacterial and fungal BSI outbreaks and were implicated as the source of infection in eight (33%) outbreaks. These included outbreaks caused by Candida parapsilosis (2), Serratia marcescens (2), Klebsiella oxytoca (1), Pseudomonas cepacia (1), Acinetobacter calcoaceticus (1), and one polymicrobial bacteremia outbreak due to Acinetobacter, Pseudomonas, Citrobacter, and Enterobacter species. In all eight outbreaks, reusable transducers improperly disinfected or fitted with domes that had been improperly sterilized served as reservoirs for the organism. Compared with nosocomial BSI outbreaks not related to transducers, those in which transducers were implicated as a reservoir involved a larger mean number of patients (24 v 9; P = 0.007), and were significantly more likely to involve intensive care unit patients (23/24 v 3/9; P = 0.025) and to have a longer mean duration (11 v 3 months; P= 0.007). These findings show that the characteristics of transducer- and non-transducer-related BSI outbreaks differ, and that centers using intravascular pressuremonitoring devices must be aware of and implement recommended infection control strategies for care and maintenance of these devices.

Type
Editorial
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 2 , February 1989 , pp. 54 - 59
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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References

1. Emergency Care Research Institute: Evaluation, blood pressure monitors. Health Dev 1975: 5:8–22.Google Scholar
2. Warner, HR, Gardner, RM, Toronto, AF: Computer-based monitoring of cardiovaseular functions in post-operative patients. Circulation 1968; 37(suppl 2):68–74.CrossRefGoogle Scholar
3. Engelman, K, Braunwals, E: Hypotension and the shock syndrome. in Wintrobe, M, Thorn, GW, Adams, R. et al (eds): Harrison's principles of Internal Medicine. ed 7. New York. McGraw-Hill Book Company. 1974. P 188.Google Scholar
4. Weinstein, RA, Emori, GT, Anderson, RI., et al: Pressure transducers as a source of bacteremia after open heart surgery: Report of an outbreak and guidelines for prevention. Chest 1976; 69:338–344.CrossRefGoogle ScholarPubMed
5. Centers for Disease Control: Transducer-associated bacteremia—North Carolina. MMWR 1975; 21:295.Google Scholar
6. Walton, JR, Shapiro, BA, Harrison, RA. et al: Serratia bacteremia from mean arterial pressure monitors. Anesthesia 1975; 13: 113–114.Google Scholar
7. Donowitz, LG, Marsik, FJ, Hoyt, JW. et al: Serratia marcescens bacteremia from contaminated pressure Transducers. JAMA 1976; 242:936–938.Google Scholar
8. Aduan, RP, Lannini, PB, Salaki, J: Nosocomial bacteremia associated with contaminated blood pressure transducers: Report of an outbreak and a review of the literature. Am J Infect Control 1980: 8:33–40 Google Scholar
9. Weinstein, RA, Stamm, WE, Kramer, L. et al: Pressine monitoring devices: Overlooked source of nosocomial inlection. JAMA 1976; pp 936–938.Google Scholar
10. Centers for Disease Control: Guidelines for prevention of intravascular infection. Infect Control 1982: 3:61–72.Google Scholar
11. Buxton, AE, Anderson, RI, Klimer, J. et al: failure of disposable domes to prevent septicetmia acquired from contaminated pressure transducers. Chest 1978: 74:508–513.Google Scholar
12. Dean, AD, Dean, JA, Burton, AD: Epi-info Epidemiologie Software User's Manual. Adanta. Epidemiology Program Office. Centers for Disease Control. 1988.Google Scholar
13. Retatillian, HF: Infection control with invasive pressure monitoring devices. APIC J 1979; 7:13–17.Google Scholar
14. Solomon, SL, Alexander, H, Eley, JW. et al: Nosocomial fungemia in neonates. Prdiatr Infect Dis 1980; 5:680–685.CrossRefGoogle Scholar
15. Weems, JJ, Cumberland, ME, Ward, J. et al: Candida parapsilosis fungemia associated with parenteral nutrition and comtaminated blood pressure trnsducers. J Clin Microbiol 1987; 25: 1029–1032.CrossRefGoogle Scholar
16. Maki, DG: Epidemic nosocomial bacteremias, in Handbook on Hospital Acquired Infection. West Palm Beach. CRC Press. Inc. 1981. pp 371–512.Google Scholar
17. Maki, DG; Nosocomial bacteremia: An epidemiologic overview. Am J Med 1981; 70:719–732.Google Scholar
18. Hamory, BH: Nosocomial bloodstream and intravascular device-related infection, in Wenzel, RP: Prevention and control of Nosocommal Infections. Baltimore. Williams & Wilkins. 1987. pp 283–319.Google Scholar
19. Band, JD, Maki, DG: Infections caused by arterial catheters used for hemodynamic monitoring. Am J Med 1979; 67:735–741.CrossRefGoogle ScholarPubMed
20. Salzman, TC, Clark, JJ, Klemm, L: Hand contamination of personnel as a mechanism of cross-iufection in nosocomial infections. Antimicrob Agents Chemother 1967; pp 97–100.Google ScholarPubMed
21. Platt, R, Lehr, JL. Marino, S. et al: Safe and cost-effective cleaning of pressure transducers. Infect Control Hosp Epidemial 1988; 9: 109–116.Google Scholar
22. Wenzel, RP, Thompson, RL. Landry, SM. et al: Hospital-acquired infections in intensive care unit patients: An overview with emphasis on epidemics. Infect Control 1983: 4:371–375.Google Scholar
23. McGowan, JE Jr, Parrott, PL, Duty, VP: Nosocomial bacteremia: Potential for prevenlion of procedure-related cases. JAMA 1977; 237:2737–2739.Google Scholar
24. Spengler, RF, Greenough, WB III: Hospital costs and mortality attributed to nosocomial bacteremias. JAMA 1978; 210:2455–2159.Google Scholar
25. Jarvis, WR, White, J, Culver, D. et al: Intensive care unit surveillance for nosocomial infections: A national perspective. Association for practinioners in Infection Control Annual Conference, Dallas, Texas. May 1-6. 1988.Google Scholar
26. McClish, DK, Russo, A, Franklin, C. et al: Profile of medical ICU vs ward patients in am acute care hospital. Gril Care Med 1985: 13:381–386.Google Scholar
27. Henning, RJ, McClish, D, Daly, B et al: Clinical characteristics and resource utilization of ICU patients: Implications for organization of intensive care. Crit Care Med 1987; 15:264–269.CrossRefGoogle ScholarPubMed
28. Stratton, CW: Bacterial infection from intravascular monitoring devices. Infect Control 1983: 1:399–401.Google Scholar