Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-18T15:28:46.119Z Has data issue: false hasContentIssue false

A Cluster of Hemodialysis-Related Bacteremia Linked to Artificial Fingernails

Published online by Cambridge University Press:  02 January 2015

Fred M. Gordin*
Affiliation:
Washington, DC, Veterans Affairs Medical Center, Washington, DC Department of Medicine, the George Washington University, Washington, DC
Maureen E. Schultz
Affiliation:
Washington, DC, Veterans Affairs Medical Center, Washington, DC
Ruth Huber
Affiliation:
Washington, DC, Veterans Affairs Medical Center, Washington, DC
Sabiha Zubairi
Affiliation:
Washington, DC, Veterans Affairs Medical Center, Washington, DC
Frida Stock
Affiliation:
Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Washington, DC
Joseph Kariyil
Affiliation:
Washington, DC, Veterans Affairs Medical Center, Washington, DC Department of Medicine, the George Washington University, Washington, DC
*
Infectious Diseases (151B), Veterans Affairs Medical Center, 50 Irving Street NW, Washington, DC 20422 (fred.gordin@va.gov)

Abstract

We examined a cluster of 5 hemodialysis patients who contracted gram-negative bacteremia. A nurse who used an artificial fingernail to open a vial of heparin that was mixed to make a flush solution had a culture of an artificial fingernail specimen positive for Serratia marcescens. The typing of the S. marcescens strains isolated from the 5 patients and the nurse showed them to be identical. This finding provides strong support for policies prohibiting artificial nails for healthcare workers in all hemodialysis units.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Boyce, IM, Pittet, D, Healthcare Infection Control Practices Advisory Committee. Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR Recomm Rep 2002;51(RR-16):2933.Google ScholarPubMed
2.Passaro, DJ, Waring, L, Armstrong, R, et al.Postoperative Serratia marcescens wound infections traced to an out-of-hospital source. J Infect Dis 1997;175:992995.CrossRefGoogle Scholar
3.Parry, MF, Grant, B, Yukna, M, et al.Candida osteomyelitis and diskitis after spinal surgery: an outbreak that implicates artificial nail use. Clin Infect Dis 2001;32:352357.CrossRefGoogle ScholarPubMed
4.Foca, M, Jakob, K, Whittier, S, et al.Endemie Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000:343: 695700.CrossRefGoogle Scholar
5.Moolenaar, RL, Crutcher, JM, San Joaquin, VH, et al.A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp: Epidemiol 2000;21:8085.CrossRefGoogle Scholar
6.Gupta, A, Delia-Latta, P, Todd, B, et al.Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infect Control Hosp Epidemiol 2004;25:210215.Google Scholar
7.Allon, M. National Kidney Foundation: Review—dialysis catheter-related bacteremia: treatment and prophylaxis. Am J Kidney Dis 2004;44:779791.Google Scholar
8.Jaber, BL. Bacterial infections in hemodialysis patients: pathogenesis and prevention. Kidney Int 2005;67:25082519.CrossRefGoogle ScholarPubMed
9.Tsay, R-W, Lin, L-C, Chiou, C-S, et al.Alcaligenes xylosoxidans bacteremia: clinical features and microbiological characteristics of isolates. J Microbiol Immunol Infect 2005;38:194199.Google ScholarPubMed
10.McNeil, SA, Foster, CL, Hedderwick, SA, Kauffman, CA. Effect of hand cleansing with antimicrobial soap or alcohol-based gel on microbial colonization of artificial fingernails worn by health care workers. Clin Infect Dis 2001;32:367371.CrossRefGoogle ScholarPubMed