A Cluster of Central Line–Associated Bloodstream Infections Due to Rapidly Growing Nontuberculous Mycobacteria in Patients with Hematologic Disorders at a Japanese Tertiary Care Center: An Outbreak Investigation and Review of the Literature

BACKGROUNDRapidly growing nontuberculous mycobacteria (RGM) are considered rare pathogens, causing central line–associated bloodstream infection. We identified an outbreak of central line–associated bloodstream infection due to RGM at a hematology-oncology ward during a 5-month period.DESIGNOutbreak investigation and literature review.SETTINGA Japanese tertiary care center.PATIENTSAdults who were hospitalized at the hematology-oncology ward from October 15, 2011, through February 17, 2012.RESULTSA total of 5 patients with a bloodstream infection due to RGM (4 cases ofMycobacterium mucogenicumand 1 case ofMycobacterium canariasenseinfection) were identified; of these, 3 patients had acute myeloid leukemia, 1 had acute lymphocytic leukemia, and 1 had aplastic anemia. Four of the 5 patients received cord blood transplantation prior to developing the bloodstream infection. All central venous catheters in patients with a bloodstream infection were removed. These patients promptly defervesced after catheter removal and their care was successfully managed without antimicrobial therapy. Surveillance cultures from the environment and water detectedM. mucogenicumandM. canariasensein the water supply of the hematology-oncology ward. The isolates from the bloodstream infection and water sources were identical on the basis of 16S-rRNA gene sequencing.CONCLUSIONSThe source of RGM in the outbreak of bloodstream infections likely was the ward tap water supply. Awareness of catheter-related bloodstream infections due to nontuberculous mycobacteria should be emphasized, especially where immunocompromised patients are at risk. Also, using antimicrobials after catheter removal to treat central line–associated bloodstream infection due to RGM may not be necessary.Infect Control Hosp Epidemiol 2015;36(1): 76–80

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The Impact of COVID-19 Response on Central Line Associated Bloodstream Infections and Blood Culture Contamination Rates at a Tertiary Care Center in Greater Detroit Area

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1335 ◽

2020 ◽

pp. 1-15

Author(s):

Jennifer LeRose ◽

Avnish Sandhu ◽

Jordan Polistico ◽

Joe Ellsworth ◽

Mara Cranis ◽

...

Keyword(s):

Blood Culture ◽

Care Center ◽

Tertiary Care ◽

Bloodstream Infections ◽

Blood Stream ◽

Central Line ◽

Tertiary Care Center ◽

Blood Stream Infections ◽

Detroit Area ◽

The Impact

Abstract A comparative retrospective study to quantify the impact of Coronavirus Disease 2019 (COVID-19) on patient safety. We found a statistically significant increase in central line-associated blood stream infections and blood culture contamination rates during the pandemic. Increased length of stay and mortality was also observed during COVID-19.

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Insertion site inflammation was associated with central-line–associated bloodstream infections at a tertiary-care center, 2015–2018

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.445 ◽

2020 ◽

pp. 1-3

Author(s):

Takaaki Kobayashi ◽

Gosia S. Clore ◽

Mary E. Kukla ◽

Mohammed Alzunitan ◽

Jeffrey Kritzman ◽

...

Keyword(s):

Care Center ◽

Tertiary Care ◽

Insertion Site ◽

Bloodstream Infections ◽

Central Line ◽

Tertiary Care Center ◽

Central Line Insertion ◽

Line Insertion ◽

Automated Surveillance ◽

Site Evaluation

Abstract There are currently no guidelines for central-line insertion site evaluation. Our study revealed an association between insertion site inflammation (ISI) and the development of central-line–associated bloodstream infections (CLABSIs). Automated surveillance for ISI is feasible and could help prevent CLABSI.

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Respiratory extracorporeal membrane oxygenation and central-line–associated bloodstream infection: Experience at a tertiary-care center during the coronavirus disease 2019 (COVID-19) pandemic

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.331 ◽

2021 ◽

pp. 1-3

Author(s):

Shimpei Harita ◽

Jun Hamaguchi ◽

Keiki Shimizu ◽

Hitoshi Honda

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Bloodstream Infection ◽

Care Center ◽

Tertiary Care ◽

Central Line ◽

Tertiary Care Center ◽

Membrane Oxygenation

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409. Changing Epidemiology of Fungal Bloodstream Infections in a Tertiary Care Center in India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.420 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S156-S157

Author(s):

Vidya Menon ◽

Binny P P ◽

Fabia E T ◽

Sanjeev Singh ◽

Keith S Kaye ◽

...

Keyword(s):

Care Center ◽

Tertiary Care ◽

Bloodstream Infections ◽

Tertiary Care Center

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Prevalence and species spectrum of both pulmonary and extrapulmonary nontuberculous mycobacteria isolates at a tertiary care center

International Journal of Mycobacteriology ◽

10.1016/j.ijmyco.2016.06.008 ◽

2016 ◽

Vol 5 (3) ◽

pp. 288-293 ◽

Cited By ~ 26

Author(s):

Jyoti Umrao ◽

Dharamveer Singh ◽

Amreen Zia ◽

Swati Saxena ◽

Surendra Sarsaiya ◽

...

Keyword(s):

Nontuberculous Mycobacteria ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center

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Effect of intensive education and training of nurses on ventilator-associated pneumonia and central line-associated bloodstream infection incidence in intensive care unit at a tertiary care center in North India

Indian Journal of Critical Care Medicine ◽

10.4103/ijccm.ijccm_259_17 ◽

2017 ◽

Vol 21 (11) ◽

pp. 779-782 ◽

Cited By ~ 2

Author(s):

Vikas Saini ◽

Komal Gandhi ◽

Kulbeer Kaur ◽

Lakshminarayana N. Yaddanapudi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Care Center ◽

Tertiary Care ◽

Central Line ◽

North India ◽

Ventilator Associated Pneumonia ◽

Tertiary Care Center ◽

Intensive Education ◽

And Training

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Experience With Ceftolozane-Tazobactam for the Treatment of Serious Pseudomonas aeruginosa Infections in Saudi Tertiary Care Center

Infectious Diseases Research and Treatment ◽

10.1177/1178633720905977 ◽

2020 ◽

Vol 13 ◽

pp. 117863372090597 ◽

Cited By ~ 1

Author(s):

M Bosaeed ◽

A Ahmad ◽

A Alali ◽

E Mahmoud ◽

L Alswidan ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Clinical Success ◽

Care Center ◽

Tertiary Care ◽

Bloodstream Infections ◽

Signs And Symptoms ◽

Central Line ◽

Multidrug Resistant ◽

Resistance Mechanisms ◽

Duration Of Treatment

Introduction: Multidrug-resistant Pseudomonas aeruginosa isolates have multiple resistance mechanisms, and there are insufficient therapeutic options to target them. Ceftolozane-tazobactam is a novel antipseudomonal agent that contains a combination of an oxyimino-aminothiazolyl cephalosporin (ceftolozane) and a β-lactamase inhibitor (tazobactam). Methods: A single-center retrospective observational study between January 2017 and December 2018 for patients who had been diagnosed with carbapenem-resistant P aeruginosa infections and treated with ceftolozane-tazobactam for more than 72 hours. We assessed clinical success based on microbiological clearance as well as the clinical resolution of signs and symptoms of infection. Results: A total of 19 patients fit the inclusion criteria, with a median age was 57 years, and 53% were female. The types of infections were nosocomial pneumonia, acute bacterial skin, and skin structure infections; complicated intra-abdominal infections; and central line–associated bloodstream infections. All of the isolates were resistant to both meropenem and imipenem. The duration of therapy was variable (average of 14 days). At day 14 of starting ceftolozane-tazobactam, 18 of 19 patients had a resolution of signs and symptoms of the infection. Only 14 of 19 patients (74%) had proven microbiological eradication observed at the end of therapy. During therapy, there was no adverse event secondary to ceftolozane-tazobactam, and no Clostridium difficile infection was identified. The 30-day mortality rate was 21% (4/19). Conclusions: Multidrug-resistant P aeruginosa infection is associated with high mortality, which would potentially be improved using a new antibiotic such as ceftolozane-tazobactam. Studies are required to explain the role of combination therapy, define adequate dosing, and identify the proper duration of treatment.

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Effectiveness of a catheter-associated bloodstream infection bundle in a Thai tertiary care center: A 3-year study

American Journal of Infection Control ◽

10.1016/j.ajic.2009.08.017 ◽

2010 ◽

Vol 38 (6) ◽

pp. 449-455 ◽

Cited By ~ 34

Author(s):

Anucha Apisarnthanarak ◽

Kanokporn Thongphubeth ◽

Chananart Yuekyen ◽

David K. Warren ◽

Victoria J. Fraser

Keyword(s):

Bloodstream Infection ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center

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A Retrospective Analysis of Etiology and Outcomes of Refractory Capd Peritonitis in a Tertiary Care Center from North India

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00145 ◽

2018 ◽

Vol 38 (6) ◽

pp. 441-446 ◽

Cited By ~ 2

Author(s):

Venkatesh Thammishetti ◽

Anupama Kaul ◽

D.S. Bhadauria ◽

Karthikeyan Balasubramanian ◽

Narayan Prasad ◽

...

Keyword(s):

Prognostic Factors ◽

Care Center ◽

Tertiary Care ◽

Morbidity And Mortality ◽

North India ◽

Catheter Removal ◽

Tertiary Care Center ◽

Technique Survival ◽

Refractory Peritonitis ◽

Culture Negative

Background Refractory peritonitis is defined as failure of clearance of peritoneal fluid despite 5 days of appropriate antibiotic therapy. Catheter removal decreases morbidity and mortality. Data on the outcomes of refractory peritonitis and of reinitiation of peritoneal dialysis (PD) in this group of patients are sparse. The present study analyzed etiology, outcomes, and prognostic factors of refractory peritonitis as well as survival of the reinitiation of the technique. Methods This was a single-center retrospective study that included 90 patients of refractory continuous ambulatory PD (CAPD) peritonitis at a tertiary care center in North India. We collected information regarding symptomatology, causes, prognostic factors, and outcomes of refractory peritonitis. Results Ninety patients suffered 93 episodes of refractory peritonitis. Fungal peritonitis was the most common cause of refractory peritonitis. Twenty nine (31%) episodes were culture- negative. We observed no difference between culture-positive and culture-negative peritonitis. Out of 90 patients, 54 (60%) recovered while 36 (40%) died. Septic shock at presentation alone was significantly associated with mortality in our study. The immediate mortality of refractory peritonitis is high. Even in patients who were shifted to permanent hemodialysis, 33% died in the first 3 months. Mean duration of technique survival after reinitiation was 23 months (1 – 85 months). Among the 12 patients who were reinitiated on CAPD, 5 patients had technique failure due to refractory peritonitis or ultrafiltration (UF) failure. Conclusion Refractory peritonitis is associated with significant morbidity and mortality despite catheter removal. Reinitiation is confounded by residual infection, which is a concern for poor technique survival, and high immediate mortality.

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