August 25, 2016
(September 2016)—Bacterial Outbreak Highlights the Need for Basic Infection Prevention Measures
There was a recent outbreak of Pseudomonas aeruginosa (Ps. aeruginosa) in a Maryland Neonatal Intensive Care Unit (NICU). Although Ps. aeruginosa is common in the hospital setting, finding it in the NICU is "a bit odd," according to William Schaffner, MD, an infectious diseases specialist at Vanderbilt University, Nashville, Tennessee, and medical director at the National Foundation for Infectious Diseases1.
Pseudomonas is an adaptable bacteria that seeks out the weak and immunocompromised. It is found in soil and water, but can spread via clothing, respiratory tract secretions, contaminated environmental surfaces and especially hands2. Because moisture helps it thrive, NICUs opt to use sterile water to minimize opportunities for infection.
The Centers for Disease Control and Prevention (CDC) estimates that 51,000 healthcare-associated Ps. aeruginosa infections occur in the United States annually3. Thirteen percent ― or 6,000 ― of these infections are multidrug-resistant attributing to roughly 400 deaths per year4. It is important to closely monitor water sources within healthcare facilities to minimize risk of transmission and to help identify the culprit during a cluster event. More importantly, however, healthcare providers must also be diligent in monitoring hand hygiene compliance to eradicate a possible mode of transmission- the hands! Once colonization occurs in a single patient, "the usual way bacteria would spread would be via the hands of the caregivers," Dr. Schaffner said. Wearing gloves might protect the healthcare worker, but not the patient. "It doesn't take but an occasional lapse to permit the transmission of bacteria5.”
So here we are, once again, looking at hand hygiene - the most basic, yet, the most difficult practice to control within the healthcare setting. It is a simple concept learned as potty-training toddlers, heartily singing a tune while scrubbing to clean those fingers. As healthcare workers preoccupied with busy workloads, we often forget about the importance of frequent hand washing. Though the source of the Maryland outbreak has not yet been determined, it is a renewed call to action for every healthcare facility. The basic infection prevention measures cannot be forgotten. It is everyone’s responsibility to be vigilant and prevention will prevail.
About the author: Frances (Fran) K. Canty, MA, BSN, RN, VA-BC™ Medical Science Liaison, Northeast Region. Fran Canty received a Bachelor’s Degree in Nursing from Wagner College in New York and a Master of Arts Degree in Nursing from New York University. She is currently a Medical Science Liaison for PDI Healthcare, a division of PDI, Inc. Fran is board certified in Vascular Access (VA-BC™) and is also a certified SERVSAFE® Food Protection Manager Certification. She is currently an active member of many professional organizations, including Association of Professionals in Infection Control and Epidemiology (APIC), Society of Hospital Epidemiology of America (SHEA), Infectious Disease Society of America (IDSA), Association for Vascular Access (AVA), Infusion Nurses Society (INS), and National Association of Neonatal Nurses (NANN). Contact Information: Email: firstname.lastname@example.org / Phone: (845)-323-0375
1 Medscape, Maryland NICU Still Taking Action After Pseudomonas www.medscape.com/viewarticle/867595
2 Centers for Disease Control and Prevention (CDC) website:http://www.cdc.gov/hai/organisms/pseudomonas.html
3 Centers for Disease Control and Prevention (CDC) website: http://www.cdc.gov/drugresistance/biggest_threats.html
4 Centers for Disease Control and Prevention (CDC) website: http://www.cdc.gov/hai/organisms/pseudomonas.html
5 Medscape, Maryland NICU Still Taking Action After Pseudomonas www.medscape.com/viewarticle/867595