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Ralstonia spp. in a dialysis unit: an experience in the identification and control of an outbreak / Ralstonia spp. en una unidad de diálisis: experiencia en la identificación y control de brote
Saldarriaga-Quintero, Eliana Andrea; Mosquera-Palacios, Yanira; Pinzón-Gómez, Elisa María; Lesmes-Duque, María Cristina; Victoria-Garcia, Maria Constanza; Hurtado-Palacios, Isabel Cristina.
  • Saldarriaga-Quintero, Eliana Andrea; Valle del Cauca Departmental Health Secretariat. Cali. CO
  • Mosquera-Palacios, Yanira; Valle del Cauca Departmental Health Secretariat. Cali. CO
  • Pinzón-Gómez, Elisa María; Valle del Cauca Departmental Health Secretariat. Cali. CO
  • Lesmes-Duque, María Cristina; Valle del Cauca Departmental Health Secretariat. Cali. CO
  • Victoria-Garcia, Maria Constanza; Valle del Cauca Departmental Health Secretariat. Cali. CO
  • Hurtado-Palacios, Isabel Cristina; Valle del Cauca Departmental Health Secretariat. Cali. CO
Infectio ; 24(4): 243-247, oct.-dic. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1114876
ABSTRACT
Abstract

Objective:

to describe an experience in identification and control of an outbreak of Ralstonia spp. in a renal unit. Material and

Method:

an epidemiological investigation of a hospital outbreak in 2 sites and extramural service of a renal unit. The investigation included patients who presented fever or chills, during or after dialysis, and who had positive blood culture for Ralstonia spp.

Results:

Of 769 hemodialysis patients, 124 were identified with bacteremia by Ralstonia spp.; of these, 98.4% had catheter access and 1.6% had fistula. The overall attack rate was 16.1% and the case fatality rate was 0.8%. Environmental cultures were taken and drugs and devices were tracked. Several cultures were taken of the prefilled heparin following the methods described in the International Pharmacopoeia. However, it was the technique of microbial isolation recommended by experts that enabled the isolation of the microorganism and confirmed the source.

Conclusions:

The outbreak described exceeded the number of patients affected documented in literature. It was caused by a contaminated batch of heparin. Evidence is provided of a recommended by expert technique used for the isolation of Ralstonia spp. in order to achieve control of outbreaks in a timely manner, minimizing clinical, economic, and social impact.
RESUMEN
Resumen

Objetivo:

describir la experiencia en la identificación y control de un brote por Ralstonia spp. en una unidad renal. Material y

Método:

investigación epidemiológica de brote hospitalario en 2 sedes y servicio extramural de una unidad renal. Se incluyeron pacientes que presentaron fiebre o escalofrío, durante o después de la terapia dialítica, y que tuvieran hemocultivo positivo para Ralstonia spp.

Resultados:

De los 709 pacientes para hemodiálisis, se identificaron 124 con bacteriemia por Ralstonia spp., 98,4% tenían acceso por catéter. La tasa de ataque global fue del 16,1% y la tasa de letalidad 0,8%. Se realizaron cultivos ambientales y trazabilidad de medicamentos y dispositivos, pero ante la presencia de casos extramurales la hipótesis fue redireccionada. La heparina prellenada había sido cultivada en varias oportunidades siguiendo la metodología de la farmacopea internacional. Sin embargo, la técnica de aislamiento microbiano recomendada por expertos fue la que permitió aislar el microorganismo y confirmar la fuente.

Conclusiones:

El brote que se describe excedió el número de pacientes documentados en la literatura y fue causado por un lote contaminado de heparina. Se aporta evidencia de una técnica recomendada por expertos utilizada para el aislamiento de Ralstonia spp. a fin de lograr el control de brotes de manera oportuna, minimizando el impacto clínico, económico y social.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Ralstonia / Dialysis Type of study: Diagnostic study / Prognostic study Limits: Humans / Male Language: English Journal: Infectio Journal subject: Communicable Diseases Year: 2020 Type: Article Affiliation country: Colombia Institution/Affiliation country: Valle del Cauca Departmental Health Secretariat/CO

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Full text: Available Index: LILACS (Americas) Main subject: Ralstonia / Dialysis Type of study: Diagnostic study / Prognostic study Limits: Humans / Male Language: English Journal: Infectio Journal subject: Communicable Diseases Year: 2020 Type: Article Affiliation country: Colombia Institution/Affiliation country: Valle del Cauca Departmental Health Secretariat/CO