Achromobacter species (sp.) outbreak caused by hospital equipment containing contaminated water: risk factors for infection

Summary

Background

Nosocomial outbreaks of urinary tract infections caused by Achromobacter spp. have been rare in recent decades. The aim of this research was to identify the origin of an Achromobacter spp. outbreak, conduct multi-modal infection control measures, and finally, stop the outbreak. To this end, an epidemiological outbreak investigation and risk factor analysis were performed.

Methods

Achromobacter spp. was detected in 22 patients in our Urology Wards and six environmental cultures of specimens obtained from the operating rooms. Strains isolated were submitted for antimicrobial susceptibility testing. An on-site epidemiological investigation, evaluation of patient medical records, and environmental sampling were performed to identify the source of the outbreak, and implementation of infection control intervention. A case-control study was performed to analyse the potential risk factors.

Results

Environmental sampling showed that the source of the infection for 22 patients was an ISA-IIIA-type medical pressurizer containing contaminated water. A case-control analysis showed that the risk factors for infection were diagnosis of kidney/ureteral stones, surgery, placement of a double J stent and history of hospitalization in the past three months.

Conclusion

It was concluded that the outbreak occurred in patients who underwent internal lithotripsy and double J stent placement, due to contact transmission with the contaminated sensor and connecting tubes of the ISA-IIIA-type medical pressurizer.