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Long-Lasting Contamination of a Vitrectomy Apparatus With Serratia marcescens

Published online by Cambridge University Press:  02 January 2015

Ines Kappstein ,
Christian M. Schneider ,
Hajo Grundmann ,
Regina Scholz  and
Peter Janknecht
Ines Kappstein*
Affiliation:
Institute of Environmental Medicine and Hospital Epidemiology, University Hospital, Freiburg, Germany
Christian M. Schneider
Affiliation:
Institute of Environmental Medicine and Hospital Epidemiology, University Hospital, Freiburg, Germany
Hajo Grundmann
Affiliation:
Institute of Environmental Medicine and Hospital Epidemiology, University Hospital, Freiburg, Germany
Regina Scholz
Affiliation:
Institute of Environmental Medicine and Hospital Epidemiology, University Hospital, Freiburg, Germany
Peter Janknecht
Affiliation:
Department of Ophthalmology, University Hospital, Freiburg, Germany
*
Technische Univesität, Abteilung, für Infektionshygiene, Klinikum rechts der Isar, Troggerstrasse 32, 81675 München, Germany
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Abstract

Objective:

To investigate the contamination of a vitrectomy apparatus with Serratia marcescens.

Design:

Descriptive microbiological and molecular environmental study.

Setting:

An 1,800-bed university hospital.

Results:

S marcescens was found inside the vitrectomy apparatus at the pressure transducer. Molecular typing by randomly amplified polymorphic DNA-automated laser flourescence analysis and pulsed-field gel electrophoresis identified a single pattern for all strains isolated from the apparatus. Surprisingly, the contaminating strain was identical to two strains of S marcescens isolated nearly 2 years earlier from two patients who were involved in a small outbreak of acute postoperative endophthalmitis following cataract surgery at another hospital. The emergency vitrectomies in these patients were performed at our hospital with the same apparatus that was found to be contaminated 2 years later.

Conclusion:

Performing a systematic environmental search for the assumed bacterial reservoir within the system of the vitrectomy apparatus finally made it possible to find and eliminate the nidus for the gram-negative rod. Molecular typing demonstrated that all isolates belonged to a single genotype, and revealed unexpectedly a link to two vitrectomies performed 2 years earlier. The data support the hypothesis that the source of the contamination was one of these patients, and thus contamination of the apparatus was present for almost 2 years.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 3 , March 1999 , pp. 192 - 195
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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