Investigation of an outbreak of gram-negative bacteremia among hematology-oncology outpatients.
OBJECTIVE
To identify risk factors associated with an outbreak of gram-negative bacteremia (GNB).


METHODS
A university hospital.


METHODS
Hematology-oncology outpatients.


METHODS
Retrospective case-control study.


RESULTS
Thirty-eight patients developed GNB; 13 patients experienced more than one episode, and eight blood cultures grew more than one gram-negative organism. The most frequently isolated organisms were Stenotrophomonas maltophilia, Klebsiella pneumoniae, Acinetobacter baumannii, and Acinetobacter johnsonii. When the GNB patients (cases) were compared with randomly selected hematology-oncology patients (controls), central venous catheter (CVC) self-care (71% vs 39%; P=.02), and duration of recent hospital stay (median, 15 vs 4 days; P=.01) were identified as risk factors. In a logistic regression model, duration of recent hospital stay was the only risk factor significantly associated with GNB (odds ratio, 1.05; 95% confidence interval, 1.01-1.08; P<.02).


CONCLUSIONS
Hematology-oncology patients providing their own CVC care who have recently been hospitalized for more than 2 weeks may be at increased risk of GNB. CVCs should be protected from possible environmental contamination in hematologyoncology patients. Patients providing their own CVC care should undergo continued rigorous education regarding proper CVC care.
Penzak
S R
SR
Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, USA.
Gubbins
P O
PO
Stratton
S L
SL
Anaissie
E J
EJ
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D006748:Hospital Departments; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D016522:Oncology Service, Hospital; D012189:Retrospective Studies; D012307:Risk Factors