Catheter-Related Polymicrobial Bloodstream Infections among Pediatric Bone Marrow Transplant Outpatients—Atlanta, Georgia, 2007

Abstract

We speculate that infection prevention challenges in the new clinic, combined with successive needle punctures of vials, facilitated extrinsic contamination and transmission of healthcare-associated pathogens. We recommend that preservative-free single-use vials not be punctured more than once. Use of single-use prefilled saline syringes might prevent multiuse of single-use saline vials. Storage of saline outside a medication supply system might be advisable. Before opening new clinic facilities, hospitals should consider conducting a mock patient flow exercise to identify infection control challenges.

Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors

“…Thus, our protocol recommends the documentation and analysis of all BSIs in the attending paediatric cancer unit. The question of the local origin of CVAD-related BSIs may be of increased interest in case of an outbreak [57]. Only 56 % of the patients with BSI displayed neutropenia in peripheral white blood cell counts at the first day of symptoms, but-as in our previous study [47]-neutropenia significantly influenced clinical severity.…”

Polymicrobial bacterial or fungal infections: incidence, spectrum of infection, risk factors, and clinical outcomes from a large hematopoietic stem cell transplant center

“…PI is characterized by a complex interactive relationship between 2 or more microorganisms that cause infection, and is known to occur in many different anatomic sites and disease states, and with specific microorganisms . True PI has been estimated to occur in 15% of cancer patients and is associated with higher rates of mortality compared to MMI.…”

Outbreak ofTsukamurellaSpecies Bloodstream Infection among Patients at an Oncology Clinic, West Virginia, 2011–2012

“…This practice has been implicated in previous outbreaks of bacterial bloodstream infections involving outpatient oncology facilities. 15,16 When performed outside an appropriate environment (e.g., chemotherapy hood), this practice violates the injection safety component of Standard Precautions which states that bags of intravenous solution should not be a common source of supply for multiple patients. 17 In this clinic, although the saline flush syringes were prepared in a chemotherapy hood, accepted pharmacy standards for working in such a hood were not followed.…”

“…15,16,18–20 As was evident with Clinic A, not all outpatient facilities have dedicated infection control policies for patient protection nor consult regularly with individuals with training and expertise in infection prevention. Federal and state agencies establish infection control requirements for acute care hospitals.…”