Objective: To describe an outbreak of multi-resistant Pseudomonas aeruginosa bloodstream infections (MRPA-BSI) that occurred in the haematology ward of a tertiary academic hospital in Cape Town, South Africa, and determine risk factors for acquisition of MRPA-BSI. METHODS: The outbreak investigation included a search for additional cases, review of patient records, environmental and staff screening, molecular typing using pulsed-field gel electrophoresis (PFGE) and Multi-locus sequencing (MLST) and a retrospective case-control study. RESULTS: Ten MRPA-BSI cases occurred in the haematology ward between January 2010 and January 2011. The case fatality rate was 80%. Staff screening specimens were negative for MRPA and an environmental source was not identified. PFGE showed that 9/10 isolates were related. MLST showed that 3 of these 9 isolates belonged to Sequence type (ST) 233 while the unrelated isolate belonged to ST260. CONCLUSION: We have described an outbreak of MRPA-BSI occurring over an extended period of time among neutropenic haematology patients. Molecular typing confirms that the outbreak was predominantly due to a single strain. The source of the outbreak was not identified, but the outbreak appears to have been controlled following intensive infection control measures.
Reference:
Mudau, M., Jacobson, R., Minenza, N., Kuonza, L., Morris, V., Engelbrecht, H., ... & Bamford, C. (2013). Outbreak of multi-drug resistant Pseudomonas aeruginosa bloodstream infection in the haematology unit of a South African academic hospital. PloS one, 8(3), e55985. doi:10.1371/journal.pone.0055985
Mudau, M., Jacobson, R., Minenza, N., Kuonza, L., Morris, V., Engelbrecht, H., ... Bamford, C. (2013). Outbreak of multi-drug resistant Pseudomonas aeruginosa bloodstream infection in the haematology unit of a South African academic hospital. PLoS One, http://hdl.handle.net/11427/16298
Mudau, Maanda, Rachael Jacobson, Nadia Minenza, Lazarus Kuonza, Vida Morris, Heather Engelbrecht, Mark P Nicol, and Colleen Bamford "Outbreak of multi-drug resistant Pseudomonas aeruginosa bloodstream infection in the haematology unit of a South African academic hospital." PLoS One (2013) http://hdl.handle.net/11427/16298
Mudau M, Jacobson R, Minenza N, Kuonza L, Morris V, Engelbrecht H, et al. Outbreak of multi-drug resistant Pseudomonas aeruginosa bloodstream infection in the haematology unit of a South African academic hospital. PLoS One. 2013; http://hdl.handle.net/11427/16298.
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