title: Electronic ventilator temperature sensors as a potential source of respiratory tract colonization with Stenotrophomonas maltophilia.
abstract: Stenotrophomonas maltophilia (S. maltophilia) is an important cause of nosocomial infection among ventilated and immunocompromised patients, and among patients receiving broad-spectrum antimicrobials. We report a cluster of patients in a surgical intensive care unit who were colonized or infected with S. maltophilia. An epidemiological investigation was initiated after surveillance data revealed that eight patients were culture-positive from sputum for S. maltophilia in the preceding month. Review of respiratory care procedures revealed that when mechanical ventilators were serviced between patients, the electronic temperature probes used with servo-controlled humidifiers were wiped with inadequate disinfection. We collected cultures of case-patient room surfaces, sinks and ventilator equipment. S. maltophilia was recovered from room surfaces, ventilator expiratory circuits and a temperature sensor which had been kept in ambient air after disinfection. Patients and environmental isolates were examined by RAPD-PCR. Three clinical isolates and one environmental isolate had the same profile, which suggests cross-contamination or common source exposure. The outbreak was controlled by adequate disinfection of the temperature sensors. No single epidemic strain was identified but several observations support the conclusion that the temperature probes contributed to the outbreak.
authors.affiliation: Service d'Hygiène Hospitalière, Hôpital du Haut Lévêque, Groupe Hospitalier Sud, CHU de Bordeaux, France.
authors.forename: A M
authors.initials: AM
authors.lastname: Rogues
authors.forename: J
authors.initials: J
authors.lastname: Maugein
authors.forename: A
authors.initials: A
authors.lastname: Allery
authors.forename: C
authors.initials: C
authors.lastname: Fleureau
authors.forename: H
authors.initials: H
authors.lastname: Boulestreau
authors.forename: S
authors.initials: S
authors.lastname: Surcin
authors.forename: C
authors.initials: C
authors.lastname: Bebear
authors.forename: G
authors.initials: G
authors.lastname: Janvier
authors.forename: J P
authors.initials: JP
authors.lastname: Gachie
mesh_terms: D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks; D004866:Equipment Contamination; D005602:France / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D007362:Intensive Care Units; D019105:Random Amplified Polymorphic DNA Technique; D013183:Sputum / Q000382:microbiology*; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*; D013821:Thermometers / Q000382:microbiology*; D012122:Ventilators, Mechanical / Q000382:microbiology*