An Outbreak of <i>Bacillus</i> Species in a Cancer Hospital

Lc, Thuler; Velasco, Eduardo; Ca, de Souza Martins; Faria, Douglas Emygdio de; Fonseca, Da; Lm, Dias; Vm, Gonçalves

doi:10.1086/647746

Cited by 15 publications

(6 citation statements)

References 10 publications

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“…B. cereus colonizes not only the environment and skin but also the intestinal tract, as shown in stool studies of healthy subjects and hospitalized patients [13]. Autopsies of patients with fatal B. cereus bacteraemia have revealed necrotizing intestinal lesions, highlighting the association between mucositis/neutropenic enterocolitis and B. cereus bacteraemia [14], [15].…”

Section: Discussionmentioning

confidence: 99%

Bacillus cereus bacteraemia: comparison between haematologic and nonhaematologic patients

Tusgul

Prod’hom²,

Senn

et al. 2017

New Microbes and New Infections

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Bacillus cereus bacteraemia can be severe, especially among patients with haematologic malignancy. We retrospectively reviewed first episodes of true B. cereus bacteraemia (more than one positive bottle plus signs of infection) at our institution between 1997 and 2013 with the aim to compare haematologic versus nonhaematologic patients and analyse episodes with complicated outcome. Among 56 episodes of positive-blood cultures for B. cereus, 21 were considered significant. Median age was 54 years (range 23–82 years). Ten patients (48%) had a haematologic malignancy; all were neutropenic at the time of B. cereus bacteraemia. Nonhaematologic patients were either intravenous drug users (n = 3, 14%), polytraumatized (n = 3, 14%) or had multiple chronic comorbidities (n = 5, 24%). Most episodes were hospital acquired (15, 71%). Sources of bacteraemia were intravascular catheter (n = 11, 52%), digestive tract (n = 6, 29%), drug injection (n = 3, 14%) and wound (n = 1, 5%). Adequate antibiotic therapy was provided to 18 patients (86%) during a median of 17 days (range 2–253 days). The intravascular catheter was removed in eight cases (42%). Three haematologic patients had a complicated course with neurologic complications (meningoencephalitis and cerebral abscesses). Complications appeared to be associated with catheter infection (100% of complicated cases vs. 29% of noncomplicated cases). In conclusion, B. cereus bacteraemia can have a complicated course in a subset of patients, mainly those with haematologic malignancy. Catheter infection may be associated with a worse outcome with frequent neurologic complications.

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Section: Discussionmentioning

confidence: 99%

Bacillus cereus bacteraemia: comparison between haematologic and nonhaematologic patients

Tusgul

Prod’hom²,

Senn

et al. 2017

New Microbes and New Infections

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“…In order to identify reservoirs of B. cereus in the NICU, environmental samples were obtained with sterile swabs premoistened with sterile saline. An initial survey was based on potential sources of B. cereus spores known from the literature (1,4,6,13,17). Based on the results of the case control study and the surveillance study, a second survey was directed at materials used in mechanical ventilation.…”

Section: Methodsmentioning

confidence: 99%

Outbreak of Bacillus cereus Infections in a Neonatal Intensive Care Unit Traced to Balloons Used in Manual Ventilation

et al. 2000

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In 1998, an outbreak of systemic infections caused byBacillus cereus occurred in the Neonatal Intensive Care Unit of the University Hospital Vrije Universiteit, Amsterdam, The Netherlands. Three neonates developed sepsis with positive blood cultures. One neonate died, and the other two neonates recovered. An environmental survey, a prospective surveillance study of neonates, and a case control study were performed, in combination with molecular typing, in order to identify potential sources and transmission routes of infection. Genotypic fingerprinting by amplified-fragment length polymorphism (AFLP) showed that the three infections were caused by a single clonal type of B. cereus. The same strain was found in trachea aspirate specimens of 35 other neonates. The case control study showed mechanical ventilation with a Sensormedics ventilation machine to be a risk factor for colonization and/or infection (odds ratio, 9.8; 95% confidence interval, 1.1 to 88.2). Prospective surveillance showed that colonization with B. cereusoccurred exclusively in the respiratory tract of mechanically ventilated neonates. The epidemic strain of B. cereus was found on the hands of nursing staff and in balloons used for manual ventilation. Sterilization of these balloons ended the outbreak. We conclude that B. cereus can cause outbreaks of severe opportunistic infection in neonates. Typing by AFLP proved very useful in the identification of the outbreak and in the analysis of strains recovered from the environment to trace the cause of the epidemic.

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“…However, recently, it has been increasingly reported to be a cause of serious and potentially fatal infections in immunosuppressed patients with neutropenia. B. cereus has been reported to be a cause of systemic infections such as bacteremia, septicemia, meningitis, respiratory tract infections, surgical wounds, panophthalmitis, pneumonia, and endocarditis among parenteral drug abusers, patients with a suppressed immune system or intraventricular shunt, and newborns (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Bacillus Cereus Catheter-Related Bacteremia in a Patient Diagnosed with Neuroblastoma

Çakırlar¹,

Gönüllü²,

Çelik³

et al. 2015

JAREM

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Bacillus species can be found in air, water, soil, feces, and particularly in the normal flora of patients with a prolonged length of hospitalization. Therefore, isolation of these microorganisms from clinical samples is a common condition and usually regarded as contaminants. Previously, Bacillus cereus has been rarely associated with infections, but in the last few years, it has been reported with increasing frequency as the bacterial pathogen in patients with intravenous drug abuse, trauma, immunodeficiency syndrome, immunosuppressed patients with a history of underlying malignancy and granulocytopenia. In this study, we present a 3-months-old baby girl who was presented to a private health center with a complaint of not sucking well enough. After clinical examination she was diagnosed with neuroblastoma stage 4 S, metastasis was detected in the liver and bone marrow and surrenalectomy and 14 cures of chemotherapy were applied to the patient. Patient was discharged from the hospital with a permanent tunneled catheter, but she returned to the pediatric emergency department with high fever. After laboratory tests she was diagnosed with febrile neutropenia and ceftazidime and amikacin treatment was started. Ceftazidime treatment was stopped after the isolation of B. cereus from peripheral and catheter blood cultures of the patient and teicoplanin treatment was started. Permanent tunneled catheter was removed under anesthesia, and this suggested the case as a catheter-originated bacteremia after reducing fever of the patient. As a result, we suggest that B. cereus isolation in blood cultures could not everytime mean contamination, and B. cereus may cause catheter-related infections in immunosuppressed patients. (JAREM 2015; 5: 75-7)

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An Outbreak of Bacillus Species in a Cancer Hospital

Cited by 15 publications

References 10 publications

Bacillus cereus bacteraemia: comparison between haematologic and nonhaematologic patients

Bacillus cereus bacteraemia: comparison between haematologic and nonhaematologic patients

Outbreak of Bacillus cereus Infections in a Neonatal Intensive Care Unit Traced to Balloons Used in Manual Ventilation

Bacillus Cereus Catheter-Related Bacteremia in a Patient Diagnosed with Neuroblastoma

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