Increasing numbers of Rhodococcus infections at a large university hospital NHS Trust, Nottingham An investigation
Abstract number: P807
Capewell S., Palfreyman J.
Objectives: Towards the end of October 2003 an unusual organism was grown from a number of paediatric blood culture bottles from one of the children on the Oncology Ward at the Nottingham City Hospital Campus. Routine Laboratory identification Tests as to the identification and significance of this Gram-positive organism were inconclusive. The Reference laboratory subsequently identified the organism as Rhodococcus sp. (not Rh. equi). The isolation of this type of organism increased over the following months and it was decided that an epidemiological investigation was required to find the source of infection and to prevent further outbreaks in a ward of vulnerable children.
Methods: A number of epidemiological methods were engaged to assess the outbreak. These included a study as to where the patient came from, a case assessment including time from line to infection, line usage, age and sex, as well as what type of underlying disease. A review as undertaken to see if this increase in infections caused by Rhodococcus sp. was occurring elsewhere in the hospital or the United Kingdom. Finally screening and environmental swabs were taken as well as a generally survey of the ward.
Results: There were no conclusions or similarities to be drawn from the case reviews or screening swabs. This increase in Rhodococcus infections had not been noticed in any other areas of the hospital or elsewhere within the region or country. On investigation of the Ward it was found that the HEPA filters had never been changed. These were removed and swabbed. Rhodococcus sp. was grown from 3 areas of the filters. Since their removal no more cases have been seen at Nottingham University Hospitals.
Conclusions: This was a nosocomial infection. The HEPA filters were the source of the Rhodococcus sp. infections seen in the Oncology ward at Nottingham University Hospital.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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