An outbreak of Ralstonia insidiosa bloodstream infections caused by contaminated heparinized syringes.

INTRODUCTION: Ralstonia insidiosa, a gram-negative waterborne bacteria able to survive and grow in any type of water source, can cause nosocomial infections, and are considered emerging pathogens of infectious diseases in hospital settings. In this study, we report an outbreak of R. insidiosa at our center related to contaminated heparinized syringes. MATERIAL AND METHODS: The present study was conducted in a tertiary care university hospital in Turkey. An outbreak analysis was performed between September 2021 and December 2021. Microbiological samples were obtained from environmental sources and from patient blood cultures. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). To investigate the clonality of strains, all confirmed isolates were sent to the National Reference Laboratory and pulsed-field gel electrophoresis (PFGE) was used to perform molecular typing. RESULTS: Seventeen R. insidiosa isolates were identified from the blood cultures of 13 patients from various wards and intensive care units. Isolates from seven patient blood cultures and two heparinized blood gas syringes were characterized by PFGE. All isolates were found to belong to the same clone of R. insidiosa. CONCLUSION: R. insidiosa was identified as the cause of a nosocomial infection outbreak in our hospital, which was then rapidly controlled by the infection-control team. When rare waterborne microorganisms grow in blood or other body fluid cultures, clinicians and the infection-control team should be made aware of a possible outbreak.

Particle scattering during otolaryngological examinations.

PURPOSE: We aimed to analyze particle scattering during common otolaryngology examination procedures which are associated with aerosol-generating procedures. MATERIALS AND METHODS: This study was conducted with 109 volunteer patients who have participated between October 2020 and January 2021. We measured aerosol and droplet production during oropharyngeal examination, anterior rhinoscopy, rigid nasopharyngoscopy, and rigid laryngoscopy. Measurements were calculated at the beginning of the examinations and during the otolaryngological examination procedures. RESULTS: There was no significant increase when we compared the particle scattering in each examination procedure with the basal measurements. But at the end of all examination methods for each patient, there was a significant increase at each micrometer. When all examination methods are compared with each other, particle increases in the oropharyngeal examination with larger particle sizes than 0,5 µm were found to be higher than other examination methods. We analyzed six patients' measurements, who coughed, gagged, or sneezed during the nasal endoscopy procedure, there was a significant increase in terms of 0,3 µm particle scattering. CONCLUSION: When all examination methods are performed together, there is a significant particle increase in all particle sizes in the examination room at the end of the examinations. This causes otolaryngologists to be exposed to a significant particle increase at each micrometer. Because of this reason, otolaryngologists should be careful and should wear personal protective equipment while examining patients.