Management of Risks From Water and Ice From Ice Machines for the Very Immunocompromised Host: A Process Improvement Project Prompted by an Outbreak of Rapidly Growing Mycobacteria on a Pediatric Hematopoietic Stem Cell Transplant (Hsct) Unit

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Amanda GuspielSusan Kline

Abstract

BACKGROUND In 2011, pediatric hematopoietic stem cell transplant (HSCT) patients were moved from an older hospital to a new children's hospital. To minimize bacterial growth in the new hospital's water during construction, the plumbing system was flushed and disinfected before occupancy. However, 6 months after occupancy, an increased incidence of rapidly growing mycobacteria (RGM) was detected in clinical cultures. Over 10 months, 15 pediatric HSCT patients were infected, while no pediatric HSCT patients had been infected in the preceding 12 months. OBJECTIVE To determine the cause of the outbreak and to interrupt patient acquisition of RGM. METHODS Water samples were collected from water entering the hospital and from drinking water and ice machines (DWIMs) from the old and new hospitals. Total heterotrophic plate counts (HPCs, CFU/mL) of water were undertaken, and select isolates were identified as RGM. RESULTS The cause of the outbreak was increased bacterial levels in the water (including RGM) in the DWIMs in the new (2011) hospital. Tests revealed higher HPCs in drinking water and ice from the DWIMs in the new hospital than in the DWIMs in the old hospital. Ultimately, HPCs were reduced by several different interventions....Continue Reading

References

Jan 19, 1999·Annual Review of Microbiology·R J WallaceD E Griffith
May 29, 1999·Applied and Environmental Microbiology·T C CovertG N Stelma
Jan 8, 2005·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Susan KlineRobert C Cooksey
May 2, 2014·The Pediatric Infectious Disease Journal·Pui-Ying Iroh TamPatricia Ferrieri

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Citations

Mar 28, 2020·International Journal of Environmental Research and Public Health·Molly M ScanlonMelissa F Cain

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