title: Outbreak of Pseudomonas aeruginosa bacteraemia in a haematology department.
abstract: BACKGROUND
  Infection by Pseudomonas aeruginosa represents a major cause of morbidity and mortality among immunocompromised patients. In Denmark, an increase in P. aeruginosa isolates from blood cultures from a haematology department prompted a hygienic audit in 2007.
  
  
  METHODS
  Blood cultures that tested positive for P. aeruginosa were collected from the laboratory information system (MADS, Skejby Hospital, Aarhus, Denmark). Environmental samples were obtained from shower heads in the department. The genotype was established by pulse field gel electrophoresis (PFGE). An audit was conducted during the outbreak and 12 months later. The audits were conducted by the method of direct observation.
  
  
  RESULTS
  Several PFGE types were involved with no clear association to isolates from environmental samples. The audit revealed poor hygiene related to the handling of central venous catheters. After optimising catheter hygiene, the number of P. aeruginosa bacteraemia cases fell significantly.
  
  
  CONCLUSIONS
  Since no clear association between patient and environmental genotype was established, it was suspected that central venous catheters were the main portal of entry. This was further supported by a simultaneous decline in bacteraemia cases with coagulase-negative staphylococci. Though several hygienic precautions were taken, the increased focus on disinfection of hubs and injection ports was presumably the more important element.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors: Endokrinologisk Afdeling M, Odense Universitetshospital, Søndre Boulevard 29, 5000 Odense C, Denmark. bsr@rsyd.dk.
authors: Benjamin Schnack
authors: BS
authors: Rasmussen
authors: Nikolas
authors: N
authors: Christensen
authors: Jan
authors: J
authors: Sørensen
authors: Flemming S
authors: FS
authors: Rosenvinge
authors: Hans Jørn
authors: HJ
authors: Kolmos
authors: Marianne N
authors: MN
authors: Skov
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology; D055499:Catheter-Related Infections / Q000453:epidemiology*; D015331:Cohort Studies; D016001:Confidence Intervals; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology; D003718:Denmark / Q000453:epidemiology; D004196:Disease Outbreaks; D004866:Equipment Contamination; D005260:Female; D006405:Hematology; D006748:Hospital Departments; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000209:etiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment