title: Bacillus species sepsis in the neonatal intensive care unit.
abstract: OBJECTIVE
  In 2002 there was an increase in the incidence of Bacillus species sepsis in our NICU that was almost completely resolved in 2003-2004 after the NICU was relocated. Our aims were to identify the source, the risk factors, and to characterize the clinical features of these infections.
  
  
  METHODS
  The epidemiological investigation commenced during the outbreak and thereafter. The patient's data were collected retrospectively and a case control study was used to analyze the risk factors.
  
  
  RESULTS
  There were eight cases of Bacillus species sepsis: five during 2002, two in 2003, and one in 2004. All infants recovered and salvaging percutaneous central venous catheter (PCVC) was successful in 4/6 of the cases. A case control study identified necrotizing enterocolitis (NEC) and PCVC as risk factors in univariate analysis but only NEC in multivariate analysis. No focal source of Bacillus bacteria was identified, but a high load of bacteria was found in the NICU's air before it was relocated.
  
  
  CONCLUSIONS
  The risk factors for Bacillus species sepsis in our NICU were NEC and PCVC. The clinical course was milder than previously described, and PCVC was successfully salvaged in most cases. The increase in the incidence could be related to the construction work connected with NICU's relocation.
authors.affiliation: Department of Neonatology, Sapir Medical Center, Tsharnichovsky Street, Kfar-Saba, Israel. amosad@post.tau.ac.il
authors.forename: Amos
authors.initials: A
authors.lastname: Adler
authors.forename: Giora
authors.initials: G
authors.lastname: Gottesman
authors.forename: Tzipora
authors.initials: T
authors.lastname: Dolfin
authors.forename: Shmuel
authors.initials: S
authors.lastname: Arnon
authors.forename: Rivka
authors.initials: R
authors.lastname: Regev
authors.forename: Sophia
authors.initials: S
authors.lastname: Bauer
authors.forename: Ita
authors.initials: I
authors.lastname: Litmanovitz
mesh_terms: D000391:Air Microbiology; D016863:Bacillaceae Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D001407:Bacillus / Q000302:isolation & purification*; D016022:Case-Control Studies; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks; D020345:Enterocolitis, Necrotizing / Q000150:complications; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D006749:Hospital Design and Construction; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007557:Israel / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology