Outbreak of Raoultella ornithinolytica infection in patients cared at a hemodialysis center
e202409052
Keywords:
Bacteraemia, Raoultella ornithinolytica, Outbreak, HaemodialysisAbstract
BACKGROUND // In July 2022, an outbreak of Raoultella ornithinolytica infection was detected in users of a hemodialysis center in Granada and central venous catheter (CVC) users. The aim of this study was to describe the development of the outbreak and the control measures implemented as well as to identify the risk factors that may have been related to its origin.
METHODS // A study of a series of thirteen cases with positive blood culture for Raoultella ornithinolytica was conducted during July 2022. Two hypotheses were considered: direct transmission through contamination of the antiseptic product or cross-contamination through the hands of healthcare personnel. A descriptive data analysis was carried out, with the calculation of attack rates and attributable risk in the exposed group (CVC users).
RESULTS // The center performed dialysis on 117 patients. 36 patients had a CVC, and 81 had an arteriovenous fistula (AVF). The total number of infected cases was 13. The attack rate was 11.1%, being 36.1% in patients with CVC and 0% in patients with AVF. The symptoms occurred between 1 and 3 hours after the start of dialysis, except in three cases that occurred after receiving dialysis in other centers. Samples of water, liquids and antiseptics were negative.
CONCLUSIONS // An outbreak of Raoultella ornithinolytica bacteraemia is confirmed, due to possible cross-contamination in the CVC handling and antisepsis process. Possibly, the germ was carried by a container of alcoholic chlorhexidine that contaminated the catheter and caused bacteremia during the hemodialysis process.
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Sêkowska A, Bogiel T, Woźniak M, Gospodarek-Komkowska E. Raoultella spp.-reliable identification, susceptibility to antimicrobials and antibiotic resistance mechanisms. J Med Microbiol [Internet]. 2020;69(2):233-238. Disponible en: http://dx.doi.org/10.1099/jmm.0.001150
Castillo-Macías A, Flores-Aréchiga A, Llaca-Díaz J, Pérez-Chávez F, Casillas-Vega N. Microbiología del género Raoultella, características clínicas y dificultades para su diagnóstico. Rev Med Inst Mex Seguro Soc [Internet]. 2018;56(5):486-490. Disponible en: https://www.redalyc.org/journal/4577/457758201009/html/
Hajjar R, Ambaraghassi G, Sebajang H, Schwenter F, Su SH. Raoultella ornithinolytica: Emergence and resistance. Infect Drug Resist [Internet]. 2020;13:1091-1104. Disponible en: http://dx.doi.org/10.2147/idr.s191387
Jain AK, Yadav R. First report of isolation and antibiotic susceptibility pattern of Raoultella electrica from table eggs in Jaipur, India. New Microbes New Infect [Internet]. 2018;21:95-99. Disponible en: http://dx.doi.org/10.1016/j.nmni.2017.11.004
Puerta-Fernandez S, Miralles-Linares F, Sanchez-Simonet MV, Bernal-Lopez MR, Gomez-Huelgas R. Raoultella planticola bacteraemia secondary to gastroenteritis. Clin Microbiol Infect [Internet]. 2013;19(5):E236-237. Disponible en: http://dx.doi.org/10.1111/1469-0691.12102
Chun S, Yun JW, Huh HJ, Lee NY. Low virulence? Clinical characteristics of Raoultella planticola bacteremia. Infection [Internet]. 2014;42(5):899-904. Disponible en: http://dx.doi.org/10.1007/s15010-014-0664-7
Ershadi A, Weiss E, Verduzco E, Chia D, Sadigh M. Emerging pathogen: a case and review of Raoultella planticola. Infection [Internet]. 2014;42(6):1043-1046. Disponible en: http://dx.doi.org/10.1007/s15010-014-0638-9
Boattini M, Almeida A, Cardoso C, Cruz CS, Machado C, Vesza Z et al. Infections on the rise: Raoultella spp., clinical and microbiological findings from a retrospective study, 2010-2014. Infect Dis (Lond) [Internet]. 2016;48(1):87-91. Disponible en: http://dx.doi.org/10.3109/23744235.2015.1082619
Demiray T, Koroglu M, Ozbek A, Altindis M. A rare cause of infection, Raoultella planticola: emerging threat and new reservoir for carbapenem resistance. Infection [Internet]. 2016;44(6):713-717. Disponible en: http://dx.doi.org/10.1007/s15010-016-0900-4
Chun S, Yun JW, Huh HJ, Lee NY. Clinical characteristics of Raoultella ornithinolytica bacteremia. Infection [Internet]. 2015;43(1):59-64. Disponible en: http://dx.doi.org/10.1007/s15010-014-0696-z
Seng P, Boushab BM, Romain F, Gouriet F, Bruder N, Martin C et al. Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature. Int J Infect Dis [Internet]. 2016;45:65-71. Disponible en: http://dx.doi.org/10.1016/j.ijid.2016.02.014
González-Castro A, Rodríguez-Borregán JC, Campos S, Pérez Canga JL. Bacteriemia relacionada con catéter causada por Raoultella ornithinolytica. Rev Esp Anestesiol Reanim [Internet]. 2018;65(2):116-118. Disponible en: http://dx.doi.org/10.1016/j.redar.2017.09.007
Motta JC, Ucros E, Rey MR, Gómez PD, Sánchez M. Características clínicas y microbiológicas de pacientes con aislamiento por Raoultella spp. en Bogotá, Colombia. Med Clin (Barc) [Internet]. 2022;158(1):20-23. Disponible en: http://dx.doi.org/10.1016/j.medcli.2020.10.024
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