A cluster of Rhodococcus (Gordona) bronchialis sternal-wound infections after coronary-artery bypass surgery

Article Abstract:

Infection of humans by species of the bacterial genus Rhodococcus is uncommon, but a hospital outbreak took place among patients who had undergone open-heart surgery within a particular time period. The methods used to identify the source of infection are described. Seven patients who developed sternal-wound infections following open-heart surgery (classified as ''cases'') were compared with those who underwent surgery in the same period but remained uninfected (''controls''; 28 people). Cases and controls were compared with respect to hospital care, concurrent medical conditions, transfusion history, and other factors. Samples were analyzed from the operating room environment and personnel, including swabs from staffs' fingers, noses, throats, and rectums. Infection began an average of 53 days after surgery and was treated with antibiotics and further surgery (necessary in four cases); all patients recovered. The only factor significantly associated with infection was the presence of Nurse A, an operating-room nurse, during the procedures. The problem-solving procedure undertaken to determine the relative importance of the risk factors is explained in the article; it included observation of coronary-artery bypass grafting surgery. Nurse A was found to have R. bronchialis on hands and scalp, and in her vagina; in addition, the organism was present in the neck skin of her dogs, in her operating-room locker, and on a heating vent in her home where one dog often lay. Careful attention to hand washing and other aseptic measures, and use of antibiotics, did not eliminate R. bronchialis from Nurse A's hands and scalp. She was reassigned to noncardiac surgical procedures, where she had no association with infection. The route of transmission was found to be from Nurse A's scalp to her hand, then to water on the outside of test tubes that rested in a water bath during the bypass surgery. This water then dripped onto the sterile surgical area or onto instrument trays when Nurse A handled instruments. Ultimately, this nurse's incorrect method of handling test tubes after they had been in the water bath was at fault. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Complications and side effects, Surgical wound infections, Disease transmission, Coronary artery bypass, Operating room personnel

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Liver failure and death after exposure to microcystins at a hemodialysis center in Brazil

Article Abstract:

Water used for hemodialysis should be monitored for infectious organisms and toxic substances. When a group of patients at a Brazilian dialysis center became ill and eventually died of liver failure, researchers identified 101 patients at the center who received dialysis that month and developed liver failure. Fifty of the patients eventually died. The center received water from a nearby reservoir but did not treat it to remove potentially deadly organisms. Analysis of water samples revealed toxins produced by blue-green algae that can affect the liver.

Patient outcomes, Mortality, Liver failure, Water, Contamination, Hemodialysis patients

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Clostridium infections associated with musculoskeletal-tissue allografts

Article Abstract:

A study was conducted to investigate the methods like allografts, which were used, for the recovery, processing, and testing of tissue. The result revealed that infections were traced to allograft implantation, to enhance tissue-transplantation safely.

Science & research, Research, Clostridium infections, Transplantation of organs, tissues, etc., Tissue transplantation, Musculoskeletal tests

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