title: Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014.
abstract: We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13-October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case-control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation.
authors.forename: Skerdi
authors.initials: S
authors.lastname: Haviari
authors.forename: Pierre
authors.initials: P
authors.lastname: Cassier
authors.forename: Cédric
authors.initials: C
authors.lastname: Dananché
authors.forename: Monique
authors.initials: M
authors.lastname: Hulin
authors.forename: Olivier
authors.initials: O
authors.lastname: Dauwalder
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouvière
authors.forename: Xavier
authors.initials: X
authors.lastname: Bertrand
authors.forename: Michel
authors.initials: M
authors.lastname: Perraud
authors.forename: Thomas
authors.initials: T
authors.lastname: Bénet
authors.forename: Philippe
authors.initials: P
authors.lastname: Vanhems
mesh_terms: D042441:Achromobacter denitrificans; D001706:Biopsy / Q000009:adverse effects; D016022:Case-Control Studies; D004196:Disease Outbreaks; D004866:Equipment Contamination; D005602:France; D016905:Gram-Negative Bacterial Infections / Q000209:etiology* / Q000382:microbiology*; D006801:Humans; D008297:Male; D020621:Ochrobactrum anthropi; D011469:Prostatic Diseases / Q000382:microbiology* / Q000473:pathology*; D013523:Surgical Equipment
keywords: Achromobacter denitrificans; Achromobacter xylosoxidans; France; Ochrobactrum anthropi; bacteria; biopsy; clinical laboratory techniques; diagnostic techniques; disease outbreaks; gram-negative bacteria; prostate; prostatic diseases; prostatitis; surgical