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Investigation of a Streptococcus viridans Pseudobacteremia Epidemic at a University Teaching Hospital*

Published online by Cambridge University Press:  21 June 2016

Deirdre L. Church  and
Heather E. Bryant
Deirdre L. Church*
Affiliation:
Departments of Microbiology and Infectious Diseases and Medicine, University of Calgary, Calgary, Alberta, Canada
Heather E. Bryant
Affiliation:
Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
*
% 12th Floor Microbiology Laboratory, Foothills Hospital, 1403 29th St. N.W., Calgary, Alberta, Canada, T2N2T9.
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Abstract

For several months in 1986, an outbreak of Streptococcus viridans pseudobacteremia occurred at a large teaching hospital. All sources of laboratory blood culture contamination were excluded. A retrospective epidemiological study indicated that one phlebotomist, “P,” collected a disproportionate number of the positive blood cultures. Further comparison of the paired blood culture results from the three months when the incidence was highest revealed a good concordance of results among all other phlebotomists (Kappa = 0.5), while P's results concurred with others less frequently than would be expected even by chance (Kappa < 0.0). Clinical follow-up showed that P did not routinely wear gloves while drawing blood and had eczema of the hands. Skin scrapings from the hands, right index finger/fingernail grew predominantly S viridans species that were compatible with those recovered from contaminated blood cultures. This epidemic demonstrated the need for early detection of this source as a cause of nosocomial pseudobacteremia.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 9 , September 1989 , pp. 416 - 421
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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Footnotes

*

Abstract presented as a poster session at the 27th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) meeting, October, 1987, New York, New York

References

1. John, JF, Bannister, R: Pseudobacteremia. Infect Control 1984; 5:69–70.CrossRefGoogle ScholarPubMed
2. Maki, DA: Through a glass darkly. Nosocomial pseudoepidemics and pseudobacteremias. Arch Int Med 1980; 130:84–87.Google Scholar
3. Weinstein, RA, Stamm, WE: Pseudoepidemics in hospitals. Lancet 1977; 2:862–864.CrossRefGoogle Scholar
4. Kaslow, RA, Mackel, DC, Mallison, GF: Nosocomial pseudobacteremia: Positive blood cultures due to contaminated benzalkonium antiseptic. JAMA 1976; 236:2407–2409.CrossRefGoogle ScholarPubMed
5. Coyle-Gilchrist, MM, Crewe, P, Roberts, G: Flavobacterium meningosepticum in the hospital environment. J Clin Pathol 1976; 29:824–826.CrossRefGoogle ScholarPubMed
6. Craven, DE, Moody, B, Connolly, MG, et al: Pseudobacteremia caused by povidone-iodine solution contaminated with Pseudomonas cepacia . N Engl J Med 1981; 305:621–623.CrossRefGoogle ScholarPubMed
7. Siegel, JD. Haley, CE, Thomassen, KA: Contaminated povidone-iodine sodium-Texas. MMWR 1989; 38:133–134.Google Scholar
8. Hoffman, PC. Arnow, RM, Goldmann, DA, et al: False-positive blood cultures: Association with nonsterile blood collection tubes. JAMA 1976: 236:2073–2075.CrossRefGoogle ScholarPubMed
9. McLeish, WA, Corrigan, EN, Elder, RH, et al: Contaminated vacuum tubes. Can Med Assoc J 1975; 122:682.Google Scholar
10. McNeil, MM, Davis, BJ, Anderson, RL, et al: Mechanism of cross-contamination of blood culture bottles in outbreaks of pseudobacteremia associated with nonsterile blood collection tubes. J Clin Microbiol 1985; 22:23–25.CrossRefGoogle ScholarPubMed
11. DuClos, TW, Hodges, GR, Killian, JE: Bacterial contamination of blood-drawing equipment: A cause of false-positive blood cultures. Am J Med Sct 1975; 266:459–463.CrossRefGoogle Scholar
12. Semel, JD, Trenholme, GM, Harris, AA, et al: Pseudomonas maltophilia pseudosepticernia. Am J Med 1978; 64:403–406.CrossRefGoogle Scholar
13. Snydman, DR. Maloy, ME Brock, SM. et al: Pseudobacteremia: False-positive blood cultures from mist tent contamination. Am J Epidemiol 1977: 106:154–159.CrossRefGoogle ScholarPubMed
14. Faris, HM, Sterling, FF: Mimi polymorpha bacteremia: False-positive cultures due to contaminated penicillinase. JAMA 1972; 219:76–77.CrossRefGoogle Scholar
15. Noble, RC, Reeves, SA: Bacillus species Pseudosepsis caused by contaminated commercial blood culture media. JAMA 1974; 230:1002–1004.CrossRefGoogle ScholarPubMed
16. Craven, DE, Lichtenberg, DA, Browne, KF, et al: Pseudobacteremia traced to cross-contamination by an automated blood culture analyzer. Infect Control 1984; 5:75–78.CrossRefGoogle ScholarPubMed
17. Gurevitch, I, Tafuro, P. Krystofiak, SP: Three clusters of Bacillus pseudobacteremia related to a radiometric blood culture analyzer. Infect Control 1984; 5:71–74.CrossRefGoogle Scholar
18. Griffin, MR, Miller, AD, Davis, AC: Blood culture contamination associated with a radiometric analyzer. J Clin Microbiol 1982; 15:567–570.CrossRefGoogle ScholarPubMed
19. Bradley, SF, Wilson, KH, Rosloniec, MA: Recurrent pseudobacteremias traced to a radiometric blood culture device. Infect Control 1987; 8:281–283.CrossRefGoogle ScholarPubMed
20. Lynch, JM, Anderson, A. Camacho, FR: Pseudobacteremia caused by Clostridium sordelli . Arch Int Med 1980; 140:65–68.CrossRefGoogle Scholar
21. Haley, RW, Schaberg, DR, Crossley, KB: Extra charges and prolongation of stayattributable tonosocomial infections: A prospective inter-hospital comparison. Am J Med 1981; 70:51–58.CrossRefGoogle Scholar
22. Rose, R, Hunting, KJ, Townsend, TR: Morbidity/mortality and economics of hospital-acquired bloodstream infections: A controlled study. South Med J 1977; 70:1267–1269.CrossRefGoogle ScholarPubMed
23. Fleiss, JL: Statistical Methods for Rates and Proportions, ed 2. New York, John Wiley and Sons, 1984.Google Scholar
24. Rosner, B: Fundamentals in Biostatistics, ed 2. Duxbury Press, Boston, 1986, p 332.Google Scholar
25. Facklam, RR, Carey, RB: Streptococciand aerococci, in Lennette, EH (ed): Manual of Clinical Microbiology, ed 4. Washington, DC, American Society for Microbiology, 1985.Google Scholar