Hepatitis B outbreak associated with a hematology-oncology office practice in New Jersey, 2009

Greeley, Rebecca; Semple, Shereen; Thompson, Nicola D.; High, Patricia; Rudowski, Ellen; Handschur, E. F.; Xia, Guoliang; Ganova-Raeva, Lilia; Crawford, Jennifer; Robertson, Corwin A.; Tan, Christina; Montana, Barbara

doi:10.1016/j.ajic.2010.11.011

Cited by 26 publications

(23 citation statements)

References 24 publications

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“…[14][15][16][17] A matter of particular concern is the infection risk due to unsafe injection practices that are associated with the use of single-dose vials for multiple patients [18][19][20] and the use of multi-dose vials. [6][7][8][9] International guidelines on preventing contamination of anaesthetic-associated medication 21,22 clearly state that preservative-free vials are single-patient, single-dose items.…”

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confidence: 99%

Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital

Heever

Scribante

Perrie

et al. 2016

Southern African Journal of Anaesthesia and Analgesia

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Background: Common practice at Chris Hani Baragwanath Academic Hospital (CHBAH) is to use boluses from a self-prepared, multi-dose phenylephrine solution to treat spinal anaesthesia-induced hypotension in patients undergoing a Caesarean section. The aims of this study were to determine if there was microbial contamination of the solutions and to evaluate whether healthcare workers adhered to appropriate labelling and aspiration practices. Methods: A sample was collected and the labelling data were documented from the solutions found in the two obstetric theatres at CHBAH over a three-month period. The samples were sent to a laboratory for microbial investigation. Results: Microbial contamination was identified in 6.4% of samples collected. The name of the solution was indicated on 100% of the containers and the concentration of the solution was on 96.4%. The date the solution was prepared was indicated on 74.6% of containers and the time the solution was prepared was on 57.3%. Only 8.2% of healthcare workers who prepared the solution confirmed it by placing a signature on the container. Labelling data were written directly on 100% of the containers and a spikedevice was used in 64.5% of the containers. Conclusions: This study demonstrated microbial contamination of the solution and may indicate an infection hazard. Healthcare workers also did not adhere to appropriate labelling and aspiration practices. This is important for all patients from a patient safety perspective and the need to improve quality of care.

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confidence: 99%

Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital

Heever

Scribante

Perrie

et al. 2016

Southern African Journal of Anaesthesia and Analgesia

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“…In response to reports of outbreaks involving outpatient oncology settings, 3,4,7,8 the CDC launched a campaign in October 2011 that featured new tools and resources to prevent infections among oncology patients. 11 These features include a basic infection control plan containing key policies and procedures that any outpatient oncology facility can implement to standardize and improve its infection prevention practices.…”

Section: Discussionmentioning

confidence: 99%

Outbreak of Pseudomonas aeruginosa and Klebsiella pneumoniae bloodstream infections at an outpatient chemotherapy center

Dobbs

Guh

Oakes

et al. 2014

American Journal of Infection Control

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

See

Nguyen

Chatterjee

et al. 2014

Infect. Control Hosp. Epidemiol.

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Objective To determine the source and identify control measures of an outbreak of Tsukamurella species bloodstream infections at an outpatient oncology facility. Design Epidemiologic investigation of the outbreak with a case control study. Methods A case was an infection in which Tsukamurella spp. was isolated from a blood or catheter tip culture during January 2011–June 2012 from a patient of the oncology clinic. Laboratory records of area hospitals and patient charts were reviewed. A case-control study was conducted among clinic patients to identify risk factors for Tsukamurella spp. bloodstream infection. Clinic staff were interviewed and infection control practices were assessed. Results Fifteen cases of Tsukamurella (T. pulmonis or T. tyrosinosolvens) bloodstream infection were identified, all in patients with underlying malignancy and indwelling central lines. Median age of case-patients was 68 years; 47% were male. The only significant risk factor for infection was receipt of saline flush from the clinic during September–October 2011 (P=0.03), when the clinic had been preparing saline flush from a common-source bag of saline. Other infection control deficiencies that were identified at the clinic included suboptimal procedures for central line access and preparation of chemotherapy. Conclusion Although multiple infection control lapses were identified, the outbreak was likely caused by improper preparation of saline flush syringes by the clinic. The outbreak demonstrates that bloodstream infections among oncology patients can result from improper infection control practices and highlights the critical need for increased attention to and oversight of infection control in outpatient oncology settings.

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Hepatitis B outbreak associated with a hematology-oncology office practice in New Jersey, 2009

Cited by 26 publications

References 24 publications

Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital

Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital

Outbreak of Pseudomonas aeruginosa and Klebsiella pneumoniae bloodstream infections at an outpatient chemotherapy center

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

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