A polymicrobial outbreak of surgical site infections following cardiac surgery at a community hospital in Florida, 2011-2012

Nguyen, Duc B.; Gupta, Neil; Abou-Daoud, Alison; Klekamp, Benjamin G; Rhone, Chaz; Winston, Tiffany; Hedberg, Trevor; Scuteri, Ana; Evans, Colonel S.C; Jensen, Bette; Moulton-Meissner, Heather; Török, Thomas J.; Berríos-Torres, Sandra I.; Noble-Wang, Judith; Kallen, Alexander J.

doi:10.1016/j.ajic.2013.11.021

Cited by 13 publications

(10 citation statements)

References 9 publications

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“…[23] A cluster of three cases developed sternal osteomyelitis following CABG; they were treated by wound debridement and negative pressure. [24] Another case after CABG was treated with vancomycin and cefotetan. [25] Similarly ceftriaxone and ciprofloxacin were used in 2013 following CABG.…”

Section: Discussionmentioning

confidence: 99%

Sternal osteomyelitis by Gordonia Bronchialis in an immunocompetent patient after open heart surgery

et al. 2019

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Gordonia is a catalase-positive, aerobic, nocardioform, Gram-positive staining actinomycete that also shows weak acid-fast staining. Several Gordonia species are commonly found in the soil. The bacterium has been isolated from the saliva of domesticated/wild dogs as well. In hospitalized patients, most commonly it is found in the setting of intravascular catheter-related infections. However, recent reports show that it is being increasingly isolated from sternal wounds, skin/neoplastic specimens and from pleural effusions. Gordonia shares many common characteristics with Rhodococcus and Nocardia. Ergo, it is commonly misrecognized as Nocardia or Rhodococcus. Since this pathogen requires comprehensive morphological and biochemical testing, it is often difficult and cumbersome to isolate the species. Broad-range Polymerase Chain Reaction (PCR) and sequencing with genes like 16S rRNA or hsp65 are used to correctly identify the species. Identification is essential for choosing and narrowing the right antimicrobial agent. Herein, we report our experience with a patient who presented with sternal osteomyelitis after infection with this elusive bug.

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Section: Discussionmentioning

confidence: 99%

Sternal osteomyelitis by Gordonia Bronchialis in an immunocompetent patient after open heart surgery

et al. 2019

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“…Providing surgical care to patients who are suspected or confirmed to have COVID‐19 in an AIIR or negative‐pressure OR is a viable strategy for decreasing the risk of transmission. However, in one study that investigated the causes of a polymicrobial outbreak of surgical site infections (SSIs) among cardiac surgery patients at a single hospital, the investigators found that the air pressure in the OR was lower than the pressure outside the OR (ie, negative pressure), which may have attributed to SSI development 49 . Perioperative leaders and staff members should discuss the risks and benefits of negative‐pressure rooms with infection preventionists, engineering personnel, and other key partners, because altering HVAC systems to create a negative‐pressure space could adversely affect surgical patients (eg, by increasing their risk for SSIs) or other areas served by the same HVAC system 50…”

Section: Sars‐cov‐2 In the Perioperative Environmentmentioning

confidence: 99%

COVID‐19 in the Perioperative Setting: Applying a Hierarchy of Controls to Prevent Transmission

Alvino¹,

Caughell²

2021

AORN Journal

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The evolution of SARS‐CoV‐2 from a zoonotic virus to a novel human pathogen resulted in the coronavirus disease 2019 (COVID‐19) global pandemic. Health care delivery and infection prevention and control recommendations continue to evolve to protect the safety of health care personnel, patients, and visitors while researchers and policymakers learn more about SARS‐CoV‐2 and COVID‐19. The perioperative setting is unique in that it exposes clinicians and personnel to increased risks through the invasive nature of surgical care. Using the Centers for Disease Control and Prevention’s Hierarchy of Controls as a model, this article presents risk mitigation strategies for preventing the transmission of COVID‐19 in the perioperative environment. The goals are to identify and eliminate potential exposure to SARS‐CoV‐2 when surgery is necessary for patients who are suspected or confirmed to have COVID‐19 or who have an unknown infection status.

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“…If personnel do not perform adequate cleaning and disinfection, blood and other body fluids that harbor pathogens may remain on equipment surfaces and lead to HAIs in susceptible surgical patients . Infection outbreaks have been attributed to contaminated OR environmental surfaces resulting from inadequate cleaning and disinfection practices …”

Section: Pathogen Transmission Via Environmental Surfacesmentioning

confidence: 99%

“…12 Infection outbreaks have been attributed to contaminated OR environmental surfaces resulting from inadequate cleaning and disinfection practices. 22,34 In both inpatient and outpatient ORs, high-touch areas-including the anesthesia professional's and RN circulator's computer mice, the OR bed, and the anesthesia medical cart 25 -contain high levels of surface contamination as measured by the presence of colony-forming units, which poses a risk for pathogen transmission and subsequent HAIs, including surgical site infections. 25,35,36 In a prospective diagnostic study, researchers used adenosine triphosphate (ATP) bioluminescence technology, which measures bioburden levels, and detected contamination on high-touch areas in six orthopedic ORs, including the light handles; computer keyboard; prep table; Clark-socket attachment; patient positioners used for total hip and spine procedures; electrosurgical unit, forced-air warming device, and tourniquet machine buttons; and the right side of the OR bed headboard.…”

Section: Pathogen Transmission Via Environmental Surfacesmentioning

confidence: 99%

Environmental Surface Hygiene in the OR: Strategies for Reducing the Transmission of Health Care–Associated Infections

Branch¹,

Amiri²

2020

AORN Journal

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Health care–associated infections (HAIs) cost billions of dollars annually in the United States and cause patient morbidity and mortality. There is increasing evidence that environmental surfaces in the OR setting, including anesthesia work areas, can harbor pathogens that can lead to HAIs. Patient‐care equipment used routinely in the OR, such as electrocardiograph wires, blood pressure cuffs, pulse oximetry probes, and monitor cables, can become contaminated with pathogens during surgical procedures; without proper cleaning and disinfection between procedures, these items pose a risk for pathogen transmission and subsequent patient infections. This article discusses the association between contaminated surfaces in the OR and the risk for HAIs. It is essential that perioperative nurses, environmental services personnel, anesthesia technicians, and anesthesia professionals properly disinfect environmental surfaces to prevent HAIs.

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A polymicrobial outbreak of surgical site infections following cardiac surgery at a community hospital in Florida, 2011-2012

Abstract: We describe an outbreak of 22 sternal surgical site infections following cardiac surgery, including 4 Gordonia infections. Possible operation room environmental contamination and suboptimal infection control practices regarding scrub attire may have contributed to the outbreak.

Cited by 13 publications

References 9 publications

Sternal osteomyelitis by Gordonia Bronchialis in an immunocompetent patient after open heart surgery

Sternal osteomyelitis by Gordonia Bronchialis in an immunocompetent patient after open heart surgery

COVID‐19 in the Perioperative Setting: Applying a Hierarchy of Controls to Prevent Transmission

Environmental Surface Hygiene in the OR: Strategies for Reducing the Transmission of Health Care–Associated Infections

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