An Outbreak of Gram-Negative Bloodstream Infections in Chronic Hemodialysis Patients

Vol. 15, No. 1, 1995

Free Abstract Article (PDF 2278 KB)

Clinical Study

An Outbreak of Gram-Negative Bloodstream Infections in Chronic Hemodialysis Patients
Sharon F. Welbel^a, Kenneth Schoendorf^b, Lee A. Bland^a, Matthew J. Arduino^a, Carmela Groves^c, Barbara Schable^a, Caroline M. O'Hara^a, Fred C. Tenover^a, William R. Jarvis^a

^aHospital Infections Program, National Center for Infectious Diseases, and
^bNational Center for Health Statistics, Centers for Disease Control and Prevention, Atlanta, Ga.;
^cMaryland Department of Health and Mental Hygiene, Baltimore, Md., USA

Address of Corresponding Author

Am J Nephrol 1995;15:1-4 (DOI: 10.1159/000168793)

Key Words

Hemodialysis
Dialyzer reuse
Klebsiella pneumoniae
Bloodstream infection
Bacteremia

Abstract

Six chronic hemodialysis patients acquired bloodstream infections (BSIs) with Klebsiella pneumoniae of the same serotype and similar plasmid profile during an 11-day period. The 6 case-patients were more likely than noncase-patients to have received dialysis during the fourth shift (p < 0.05) and to have their dialyzers reprocessed for reuse after those of the noncase-patients (p = 0.05). Investigation identified a patient during the same shift with an arteriovenous fistula infected with K pneumoniae. The dialyzer reprocessing technician did not change gloves between contacting patients and their dialyzers in the treatment area and reprocessing the case-patients' dialyzers at the end of the fourth shift. We conclude that the outbreak of BSIs was caused by cross-contamination of the case-patients' dialyzers with bacteria from the gloves of the reprocessing technician and by inadequate dialyzer disinfection. After revised dialyzer reprocessing techniques and glove-changing policies were instituted, no further clusters of BSIs occurred.

Author Contacts

Lee A. Bland, Hospital Infections Program, C-01, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 (USA)

Article Information

Received: February 24, 1994
Accepted: March 24, 1994
Published online: October 28, 2008
Number of Print Pages : 4

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