An outbreak of hemodialysis catheter-related bacteremia with sepsis caused by Streptococcus agalactiae in a hemodialysis unit

• Published in: International journal of infectious diseases Vol. 14; no. 5; pp. e418 - e422
• Main Authors: Baraboutis, Ioannis G, Doris, Konstantinos, Papanikolaou, Konstantinos, Tsagalou, Eleftheria P, Chatsiou, Konstantina, Papathanasiou, Evripidis, Platsouka, Evaggelia, Papastamopoulos, Vassilios, Belesiotou, Helen, Apostolou, Theofanis, Paniara, Olga, Skoutelis, Athanasios T
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.05.2010
• Subjects: Aged; Aged, 80 and over; Bacteremia - epidemiology; Bacteremia - microbiology; Catheter-related bacteremia; Catheters, Indwelling - microbiology; Disease Outbreaks; Female; Greece - epidemiology; Group B Streptococcus; Hemodialysis; Hemodialysis Units, Hospital - organization & administration; Humans; Infectious Disease; Invasive group B Streptococcus disease; Male; Pulmonary/Respiratory; Renal Dialysis - methods; Streptococcal Infections - drug therapy; Streptococcal Infections - epidemiology; Streptococcal Infections - microbiology; Streptococcus agalactiae; Streptococcus agalactiae - isolation & purification; Surveys and Questionnaires; Greece; Catheter-related bacteremia; Invasive group B Streptococcus disease; Streptococcus agalactiae; Hemodialysis; Group B Streptococcus
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2009.06.029

Abstract Background Rates of invasive group B Streptococcus (GBS; Streptococcus agalactiae ) disease in adults are on the rise. Invasive GBS disease can be community- or healthcare-associated. We report an outbreak of GBS catheter-related bacteremia in a hemodialysis (HD) unit. Materials and methods Two patients undergoing HD at the same outpatient HD unit were admitted on the same day (within a few hours of each other) with catheter-related GBS bacteremia. A retrospective study was undertaken at the HD unit to address risk factors for febrile illness on the last HD session day. A detailed questionnaire was completed by all HD patients treated on the same day as the two GBS patients and by all members of the nursing and medical staff. Medical and nursing records of the HD unit were reviewed, as well as infection control and catheter care practices. Patients and staff members submitted swabs for culture. Results No rectal or vaginal culture of any HD patient or staff member was positive for GBS. The development of recent febrile disease was significantly associated with the presence of a hemodialysis catheter ( p = 0.028) and care for more than 30 min by a specific nurse during the last two HD sessions ( p = 0.007). Conclusions We speculate that the GBS strain was transmitted from one patient to the other through the hands of medical personnel. No such outbreak has ever been reported in HD patients. The importance of strict infection control practices in HD units and the avoidance of catheters for long-term HD should be emphasized.