Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-19T01:02:37.969Z Has data issue: false hasContentIssue false
  • English
  • Français

Investigation of Increased Rates of Isolation of Bacillus Species

Published online by Cambridge University Press:  02 January 2015

Elissa Meites ,
Ying Taur ,
Leslie Marino ,
Melissa Schaefer ,
Janet Eagan ,
Bette Jensen ,
Margaret Williams ,
Mini Kamboj  and
Arjun Srinivasan
Elissa Meites*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Ying Taur
Affiliation:
Department of Medicine, and Infection Control, New York, New York
Leslie Marino
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Melissa Schaefer
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Janet Eagan
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York, New York
Bette Jensen
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Margaret Williams
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Mini Kamboj
Affiliation:
Department of Medicine, and Infection Control, New York, New York
Arjun Srinivasan*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
1600 Clifton Road NE, MS A-31, Atlanta, GA 30333, (emeites@cdc.gov)
1600 Clifton Road NE, MS A-35, Atlanta, GA 30333, (asrinivasan@cdc.gov)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

In 2007–2008, several US hospitals reported summertime increases in the number of clinical blood cultures positive for Bacillus species, which are common environmental bacteria.

Objective.

To investigate increased rates of isolation of Bacillus species from blood cultures, identify risk factors, and recommend control strategies.

Design.

Survey and case-control study.

Setting.

Multiple hospitals, including a cancer center.

Methods.

We surveyed 24 facilities that reported increases. We also conducted a field investigation at a hospital with a high rate, reviewing charts, collecting clinical and environmental isolates, and observing infection control procedures. A case-control study compared inpatient case patients who had any blood culture positive for Bacillus with unmatched control patients who had a blood culture with no growth during June-August 2008.

Results.

Among surveyed facilities, mean monthly rates rose from 25 to a peak of 75 Bacillus-positive blood cultures per 10,000 blood cultures performed during the period June-August. At the hospital where the case-control investigation was conducted, for most case patients (75%), the Bacillus-positive blood cultures represented contamination or device colonization rather than infection. We enrolled 48 case patients and 48 control patients; in multivariate analysis, only central venous access device use was significantly associated with case status (odds ratio, 14.0; P < .01). Laboratory testing identified at least 12 different Bacillus species (non-anthracis) among the isolates. Observation of infection control procedures revealed variability in central line care and blood sample collection techniques.

Conclusions.

Periodic increases in the environmental load of Bacillus species may occur in hospitals. Our investigation indicated that at one facility, these increases likely represented a pseudo-outbreak of Bacillus species colonizing central venous lines or their accessories, such as needleless connector devices. Vigilant attention should be paid to infection control practices when collecting blood samples for culture, to minimize the risk of contamination by environmental microorganisms.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 12 , December 2010 , pp. 1257 - 1263
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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.Vilas-Boas, GT, Peruca, AP, Arantes, OM. Biology and taxonomy of Bacillus cereus, Bacillus anthracis, and Bacillus thuringiensis. Can J Microbiol 2007;53(6):673–687.Google Scholar
2.Ohsaki, Y, Koyano, S, Tachibana, M, et al.Undetected Bacillus, pseudo-outbreak after renovation work in a teaching hospital. J Infect 2007;54(6):617–622.Google Scholar
3.Fang, Z, Ouyang, Z, Zheng, H, Wang, X, Hu, L. Culturable airborne bacteria in outdoor environments in Beijing, China. Microb Ecol 2007;54(3):487–496.CrossRefGoogle ScholarPubMed
4.Harrison, RM, Jones, AM, Biggins, PD, et al.Climate factors influencing bacterial count in background air samples. Int J Biometeorol 2005;49(3):167–178.Google Scholar
5.Hullar, MA, Kaplan, LA, Stahl, DA. Recurring seasonal dynamics of microbial communities in stream habitats. Appl Environ Microbiol 2006;72(1):713–722.Google Scholar
6.Rajkovic, A, Uyttendaele, M, Ombregt, SA, Jaaskelainen, E, Salkinoja-Salonen, M, Debevere, J. Influence of type of food on the kinetics and overall production of Bacillus cereus emetic toxin. J Food Prot 2006;69(4):847–852.Google Scholar
7.Xu, J, Moore, JE, Millar, BC. Ribosomal DNA (rDNA) identification of the culturable bacterial flora on monetary coinage from 17 currencies. J Environ Health 2005;67(7):51–55.Google Scholar
8.Brown, KL. Control of bacterial spores. Br Med Bull 2000;56(1):158–171.Google Scholar
9.Berthelot, P, Dietemann, J, Fascia, P, et al.Bacterial contamination of nonsterile disposable gloves before use. Am J Infect Control 2006;34(3):128–130.Google Scholar
10.York, MK. Bacillus species pseudobacteremia traced to contaminated gloves used in collection of blood from patients with acquired immunodeficiency syndrome. J Clin Microbiol 1990;28(9):2114–2116.CrossRefGoogle ScholarPubMed
11.Barrie, D, Hoffman, PN, Wilson, JA, Kramer, JM. Contamination of hospital linen by Badllus cereus. Epidemiol Infect 1994;113(2):297–306.Google Scholar
12.Dohmae, S, Okubo, T, Higuchi, W, et al. Bacillus cereus nosocomial infection from reused towels in Japan. J Hosp Infect 2008;69(4):361–367.CrossRefGoogle ScholarPubMed
13.Adler, A, Gottesman, G, Dolfin, T, et al.Bacillus species sepsis in the neonatal intensive care unit. J Infect 2005;51(5):390–395.CrossRefGoogle ScholarPubMed
14.Loeb, M, Wilcox, L, Thornley, D, Gun-Munro, J, Richardson, H. Bacillus species pseudobacteremia following hospital construction. Can J Infect Control 1995;10(2):37–40.Google Scholar
15.Van Der Zwet, WC, Parlevliet, GA, Savelkoul, PH, et al.Outbreak of Bacillus cereus infections in a neonatal intensive care unit traced to balloons used in manual ventilation. J Clin Microbiol 2000;38(11):4131–4136.CrossRefGoogle Scholar
16.Bryce, EA, Smith, JA, Tweeddale, M, Andruschak, BJ, Maxwell, MR. Dissemination of Bacillus cereus in an intensive care unit. Infect Control Hosp Epidemiol 1993;14(8):459–462.CrossRefGoogle Scholar
17.Castagnola, E, Conte, M, Venzano, P, et al.Broviac catheter-related bacteraemias due to unusual pathogens in children with cancer: case reports with literature review. J Infect 1997;34(3):215–218.Google Scholar
18.Blue, SR, Singh, VR, Saubolle, MA. Bacillus licheniformis bacteremia: five cases associated with indwelling central venous catheters. Clin Infect Dis 1995;20(3):629–633.CrossRefGoogle ScholarPubMed
19.Thuler, LC, Velasco, E, de Souza Martins, CA, et al.An outbreak of Bacillus species in a cancer hospital. Infect Control Hosp Epidemiol 1998;19(11):856–858.Google Scholar
20.Berger, SA. Pseudobacteremia due to contaminated alcohol swabs. J Clin Microbiol 1983;18(4):974–975.Google Scholar
21.Noskin, GA, Suriano, T, Collins, S, Sesler, S, Peterson, LR. Paenibacillus macerans pseudobacteremia resulting from contaminated blood culture bottles in a neonatal intensive care unit. Am J Infect Control 2001;29(2):126–129.CrossRefGoogle Scholar
22.Gurevich, I, Tafuro, P, Krystofiak, SP, Kalter, RD, Cunha, BA. Three clusters of Bacillus pseudobacteremia related to a radiometric blood culture analyzer. Infect Control 1984;5(2):71–74.Google Scholar
23.Ozkocaman, V, Ozcelik, T, Ali, R, et al.Bacillus spp. among hospitalized patients with haematological malignancies: clinical features, epidemics and outcomes. J Hosp Infect 2006;64(2):169–176.Google Scholar
24.Banerjee, C, Bustamante, CI, Wharton, R, Talley, E, Wade, JC. Bacillus infections in patients with cancer. Arch Intern Med 1988;148(8):1769–1774.Google Scholar
25.O'Grady, NP, Alexander, M, Dellinger, EP, et al.Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep 2002;51(RR-10):1–29.Google Scholar
26.Sacchi, CT, Whitney, AM, Mayer, LW, et al.Sequencing of 16S rRNA gene: a rapid tool for identification of Bacillus anthracis. Emerg Infect Dis 2002;8(10):1117–1123.CrossRefGoogle ScholarPubMed
27.Rupp, ME, Sholtz, LA, Jourdan, DR, et al.Outbreak of bloodstream infection temporally associated with the use of an intravascular needleless valve. Clin Infect Dis 2007;44(11):1408–1414.Google Scholar
28.Bentur, HN, Dalzell, AM, Riordan, FA. Central venous catheter infection with Bacillus pumilus in an immunocompetent child: a case report. Ann Clin Microbiol Antimicrob 2007;6:12.Google Scholar
29.Castagnola, E, Fioredda, F, Barretta, MA, et al.Bacillus sphaericus bacteraemia in children with cancer: case reports and literature review. J Hosp Infect 2001;48(2):142–145.Google Scholar
30.Freeman, R, King, B. Isolations of aerobic sporing bacilli from the tips of indwelling intravascular catheters. J Clin Pathol 1975;28(2):146–148.Google Scholar
31.Lemon, KP, Earl, AM, Vlamakis, HC, Aguilar, C, Kolter, R. Biofilm development with an emphasis on Bacillus subtilis. Curr Top Microbiol Immunol 2008;322:1–16.Google Scholar
32.Donlan, RM. Biofilms: microbial life on surfaces. Emerg Infect Dis 2002;8(9):881–890.Google Scholar
33.Perencevich, EN, McGregor, JC, Shardell, M, et al.Summer peaks in the incidences of gram-negative bacterial infection among hospitalized patients. Infect Control Hosp Epidemiol 2008;29(12):1124–1131.Google Scholar
34.Cho, SH, Shin, HH, Choi, YH, Park, MS, Lee, BK. Enteric bacteria isolated from acute diarrheal patients in the Republic of Korea between the year 2004 and 2006. J Microbiol 2008;46(3):325–330.Google Scholar
35.US Environmental Protection Agency. Biopesticide active ingredient fact sheets. Washington, DC; EPA; 2010. http://www.epa.gov/oppbppdl/biopesticides/ingredients/index.htm. Accessed October 22, 2010.Google Scholar
36.Green, M, Heumann, M, Sokolow, R, Foster, LR, Bryant, R, Skeels, M. Public health implications of the microbial pesticide Bacillus thuringiensis: an epidemiological study, Oregon, 1985-86. Am J Public Health 1990;80(7):848–852.CrossRefGoogle ScholarPubMed
37.Siegel, JP. The mammalian safety of Bacillus thuringiensis-bused insecticides. J Invertebr Pathol 2001;77(1):13–21.Google Scholar
38.Baum, JA, Johnson, TB, Carlton, BC. Bacillus thuringiensis: natural and recombinant bioinsecticide products. In: Hall, FR, Menn, IJ, eds. Biopesticides: Use and Delivery. Totowa, NJ: Humana Press; 1999:189–209.Google Scholar
39.Petrie, K, Thomas, M, Broadbent, E. Symptom complaints following aerial spraying with biological insecticide Foray 48B. N Z Med J 2003;116(1170): U354.Google Scholar
40. New York City Department of Health and Mental Hygiene. West Nile Virus. New York, NY: New York City Department of Health and Mental Hygiene; 2009. http://www.nyc.gov/html/doh/html/wnv/wnvfaq8.shtml/. Accessed April 16, 2009.Google Scholar
41.Des Jardin, JA, Falagas, ME, Ruthazer, R, et al.Clinical utility of blood cultures drawn from indwelling central venous catheters in hospitalized patients with cancer. Ann Intern Med 1999;131(9):641–647.Google Scholar