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Outbreak of bacterial meningitis among patients undergoing myelography at an outpatient radiology clinic.
- Source :
-
Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2012 Mar; Vol. 9 (3), pp. 185-90. - Publication Year :
- 2012
-
Abstract
- Purpose: To investigate an outbreak of bacterial meningitis at an outpatient radiology clinic (clinic A) and to determine the source and implement measures to prevent additional infections.<br />Methods: A case was defined as bacterial meningitis in a patient undergoing myelography at clinic A from October 11 to 25, 2010. Patients who underwent myelography and other procedures at clinic A during that period were interviewed, medical records were reviewed, and infection prevention practices were assessed. Case-patient cerebrospinal fluid (CSF) specimens, oral specimens from health care personnel (HCP), and opened iohexol vials were tested for bacteria. Bacterial isolates were compared using pulsed-field gel electrophoresis. A culture-negative CSF specimen was tested using a real-time polymerase chain reaction assay.<br />Results: Three cases were identified among 35 clinic A patients who underwent procedures from October 11 to 25, 2010. All case-patients required hospitalization, 2 in an intensive care unit. Case-patients had myelography performed by the same radiology physician assistant and technician on October 25; all patients who underwent myelography on October 25 were affected. HCP did not wear facemasks and reused single-dose iohexol vials for multiple patients. Streptococcus salivarius (a bacteria commonly found in oral flora) was detected in the CSF of 2 case-patients (1 by culture, 1 using real-time polymerase chain reaction) and in HCP oral specimens; 1 opened iohexol vial contained Staphylococcus epidermidis. Pulsed-field gel electrophoresis profiles from the case-patient S salivarius and the radiology physician assistant were indistinguishable.<br />Conclusions: Bacterial meningitis likely occurred because HCP performing myelography did not wear facemasks; lapses in injection practices may have contributed to transmission. Targeted education regarding mask use and safe injection practices is needed among radiology HCP.<br /> (Published by Elsevier Inc.)
- Subjects :
- Ambulatory Care methods
Cross Infection prevention & control
Disease Outbreaks prevention & control
Female
Follow-Up Studies
Humans
Incidence
Male
Meningitis, Bacterial etiology
Myelography methods
Retrospective Studies
Risk Assessment
United States
Cross Infection epidemiology
Disease Outbreaks statistics & numerical data
Infection Control organization & administration
Infectious Disease Transmission, Professional-to-Patient prevention & control
Meningitis, Bacterial epidemiology
Myelography adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1558-349X
- Volume :
- 9
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Radiology : JACR
- Publication Type :
- Academic Journal
- Accession number :
- 22386165
- Full Text :
- https://doi.org/10.1016/j.jacr.2011.09.018