Transcript Unit Based Champions Infection Prevention eBug Bytes

Unit Based Champions
Infection Prevention
eBug Bytes
April 2012
Bacterial Contamination Found in
Pharmacy Robots
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Drug dispensing robots designed to quickly prepare intravenous medications
in a sterile environment can harbor dangerous bacteria, During a routine
screening in 2010, personnel at Wake Forest Baptist Medical Center in
North Carolina discovered Bacillus cereusbacteria in samples dispensed by
their machine, the Intellifill IV. Bacillus is a potentially harmful bacterium that
is resistant to many commonly used disinfectants, including alcohol.
Personnel discovered the contamination through quality assurance measures
recommended by the manufacturer before any patients were harmed by the
contaminated drugs. The implications of contaminated intravenous products
can be serious, including potentially life-threatening bloodstream infections.
While any adverse events were avoided, the investigation into how the
machine became contaminated suggests that the current cleaning and
maintenance recommendations may need to be strengthened. The
investigators traced the contamination to the machine's washing station and
the tubing associated with it. Because this area is not considered a sterile
part of the robot, the manufacturer does not specify a cleaning procedure
for these parts beyond regular "fogging" with alcohol, using a spray bottle to
clean inaccessible parts. Source: David Cluck, John C. Williamson, Marty Glasgo, Daniel Diekema, Robert
Sherertz. Bacterial Contamination of an Automated Pharmacy Robot Used for Intravenous Medication
Preparation. Infection Control and Hospital Epidemiology, 2012; 33 (5): 517
Banned Antibiotics Found in
Poultry Products
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In a joint study, researchers at the Johns Hopkins Bloomberg School of
Public Health and Arizona State University found evidence suggesting
that a class of antibiotics previously banned by the U.S. government for
poultry production is still in use. Results of the study were published
March 21 in Environmental Science & Technology. The study, conducted by
the Bloomberg School's Center for a Livable Future and Arizona State's
Biodesign Institute, looked for drugs and other residues in feather meal,
a common additive to chicken, swine, cattle and fish feed. The most
important drugs found in the study were fluoroquinolones -- broad
spectrum antibiotics used to treat serious bacterial infections in people,
particularly those infections that have become resistant to old-er
antibiotic classes. The banned drugs were found in 8 of 12 samples of
feather meal in a multi-state study. The findings were a surprise to
scientists because fluoroquinolone use in U.S. poultry production was
banned by the U.S. Food and Drug Administration in 2005.

Source: Johns Hopkins University Bloomberg School of Public Health (2012, April 5). Banned antibiotics
found in poultry products. ScienceDaily.
Plaintiff says she was given
strep-tainted IV

A woman claims she acquired a rare blood infection while a patient at Winchester
Medical Center in 2010. A medical malpractice lawsuit filed late last month accuses
nurses and healthcare providers of negligence by giving the patient "an IV tainted
with streptococcus pyogenes" -- bacteria commonly associated with strep throat.

The patient went to Winchester Medical Center beginning March 28 for complaints
related to a partial bowel obstruction and underwent the placement of an
intravenous catheter in her left arm, according to the complaint. During her stay at
the hospital, nurses and other medical staff administered fluids to the patient via the
IV site, the complaint states. Staff removed the IV on March 31, 2010 and the patient
was discharged from the hospital.

"Following the removal of the IV catheter at WMC, Plaintiff's arm became severely
red, tender, and swollen at her IV site, and she was readmitted to the hospital on
April 2, 2010," the complaint states. "Blood cultures taken from the Plaintiff revealed
that the Plaintiff's blood was positive for streptococcus pyrogenes.

"Streptococcus pyogenes is extraordinarily rare when it occurs as a blood infection,"
the complaint continues. "At no time in the any relevant time period to her
admission nor following her discharge did the Plaintiff have streptococcus pyogenes
located in her throat ('strep throat')." Stanford's treating physician diagnosed the
patient with septic thrombo-phlebitis and metastic septic arthritis of her right knee.
Community-onset Clostridium difficile
linked to higher risk of surgery
Patients whose symptoms of Clostridium difficile infection (CDI) start outside of
the hospital setting have a higher risk of colectomy due to severe infection,
according to a large multicenter study funded by the Centers for Disease
Control and Prevention (CDC) and published in Infection Control and Hospital
Epidemiology, the journal of the Society for Healthcare Epidemiology of
America.
Infection from C. difficile is associated with antibiotic use and results in colitis
and diarrhea. Severe cases can be life-threatening. Colectomy, or surgical
removal of most or all of the large intestine, is the treatment of choice for
patients who have life-threatening CDI that does not respond to medical
therapy. However, it is associated with a high risk of death in these very sick
patients.
To assess rates of colectomy due to CDI, a team of researchers at 5 tertiarycare hospitals in the US collected data on CDI cases over a six year period
from 2000 and 2006. They identified 8,569 cases of CDI, and 75 patients of
this group underwent a colectomy due to severe CDI, a rate of 8.7 colectomies
per 1000 CDI cases. Patients with community-onset CDI had colectomy rates
four times higher than patients who developed symptoms while hospitalized.
Individuals who were 65 years old or older were also more likely to have a
CDI-related colectomy.
CDC: U.S. measles cases at 15-year high in
2011



Health officials say last year was the worst year for measles in the U.S. in
15 years. There were 222 cases of measles reported. Most of the cases
were imported -- either by visiting foreigners or by U.S. residents who
picked up the virus overseas. The disease had made recent headlines across
the world. Just in February 2012, a person with measles attended Super
Bowl XLVI, prompting officials to issue a warning to those in attendance.
Health official say outbreaks in the U.S. have been fueled by low vaccination
rates in Europe and elsewhere. In 2011, Europe reported more than 26,000
measles cases and nine deaths -- three times the amount of cases seen in
2007 according to the World Health Organization, HealthPop reported.
There were no deaths in the U.S. but about a third of the people were
hospitalized. At least two-thirds of the Americans who got the measles
hadn't been vaccinated.
A study conducted in 2011 and published in Pediatrics showed that more
than 10 percent of parents reject recommended vaccines for their children.
That has led some pediatricians to take the controversial step of "firing"
patients, citing fears unvaccinated children could infect other children in the
waiting room.
U.S. Marshals seize ultrasound gel product at
a New Jersey company due to bacterial
contamination

U.S. Marshals, acting at the request of the Food and Drug Administration, have
seized Other-Sonic Generic Ultrasound Transmission Gel located at
Pharmaceutical Innovations Inc. in Newark, NJ, after an FDA analysis found that
product samples contained dangerous bacteria. The seizure included all lots of
the gel product manufactured between June 2011 and December 2011. Until
they were seized, the products were held under embargo by the New Jersey
Department of Health and Senior Services at FDA's request.

Under the Federal Food, Drug, and Cosmetic Act, the seized gel is adulterated,
because product samples were contaminated with two strains of bacteria,
Pseudomonas aeruginosa and Klebsiella oxytoca. The gel is also misbranded because
it is dangerous to health when used in the manner suggested in the labeling.
These bacteria pose serious risks of infection to individuals exposed to the
product.

According to the complaint filed in the U.S. District Court for the District of
New Jersey, FDA analysis of product samples collected in February 2012
revealed the presence of the two bacterial strains.
Hospitals see decline in care-related
infections

The United States is making progress in reducing the spread
of infections to patients while they are in the hospital, the
Centers for Disease Control and Prevention said on
Thursday. Twenty-one states reported reductions in socalled "central line" bloodstream infections from 2009-2010,
according to the federal health agency, which used data from
a state-by-state tracking system.
Nationwide, there was a 32 percent decline in central line
bloodstream infections from 2009-2010, said Dr. Scott
Fridkin, deputy chief of the surveillance branch in the CDC's
division of healthcare quality promotion. The decline was
even greater at 35 percent among intensive care patients, he
said. Fridkin attributed the reduced number of healthcarerelated infections to national and state prevention efforts.