[ORT-L] Outbreak of Enterobacter cloacae


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[ORT-L] Outbreak of Enterobacter cloacae

alex at weborto
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Aug 17, 2007, 11:19 PM

Post #1 of 3 (346 views)
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[ORT-L] Outbreak of Enterobacter cloacae	Can't Post

Dear colleagues,

One of our units is now experiencing a problem with wound infection
afer THA, about 15 cases to date within 6 weeks. All cultures revealed
Enterobacter cloacae. Happily no one implant had to be removed yet.
What could be most probable cause of the outbreak? The surgeries were
absolutely routine as well as all previous. Our epidemiologist found
nothing in the theatre, air, instruments... where to seek the
bacterial agent? If the source is not cleared, what preventive
measures could be performed to decrease the risk of infection? More
thorough hair removal? Change of antibiotic profilaxis program?
Anything more? THX!

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

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jjbrooksmd at gmail
New User

Aug 19, 2007, 11:59 AM

Post #2 of 3 (344 views)
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Re: [ORT-L] Outbreak of Enterobacter cloacae [In reply to]	Can't Post

Have the assistants, scrub techs & surgeons doing these THA been
cultured? How about the gloves (not expired, etc - [holes]).

Scary - let us know what you find out.

On Aug 18, 2007, at 2:19 AM, Alexander Chelnokov wrote:

> Dear colleagues,
>
> One of our units is now experiencing a problem with wound infection
> afer THA, about 15 cases to date within 6 weeks. All cultures revealed
> Enterobacter cloacae. Happily no one implant had to be removed yet.
> What could be most probable cause of the outbreak? The surgeries were
> absolutely routine as well as all previous. Our epidemiologist found
> nothing in the theatre, air, instruments... where to seek the
> bacterial agent? If the source is not cleared, what preventive
> measures could be performed to decrease the risk of infection? More
> thorough hair removal? Change of antibiotic profilaxis program?
> Anything more? THX!
>
> --
> Best regards,
> Alexander N. Chelnokov
> Ural Scientific Research Institute
> of Traumatology and Orthopaedics
> 7, Bankovsky str. Ekaterinburg 620014 Russia
>
> ---
> [This E-mail scanned for viruses by Declude Virus]
>

Jeffrey J Brooks, MD
Hand & Upper Extremity Surgery
Orthopaedic Trauma Surgery

Orthopaedic Surgery & Sports medicine center
1290 Summer Street, #4400
Stamford, CT 06905
(203) 323-7331

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FCyran at mednet
New User

Aug 20, 2007, 11:19 AM

Post #3 of 3 (343 views)
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RE: [ORT-L] Outbreak of Enterobacter cloacae [In reply to]	Can't Post

Stands to reason that if only one of the floors/units has it, then someone/spomething on that floor is the problem. Check the nursing staff, assisstants, BP cuffs, EKG machines. I've seen nursing assistants use the same BP cuff on a patient with MRSA, and then go into another room and try to use it on a patient without it.

As far as prophylaxis - what are the sensitivities? - A resistant bug?
-F. Cyran

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org]On
Behalf Of Alexander Chelnokov
Sent: Friday, August 17, 2007 11:19 PM
To: ORT-L@www2.aaos.org
Subject: [ORT-L] Outbreak of Enterobacter cloacae

Dear colleagues,

One of our units is now experiencing a problem with wound infection
afer THA, about 15 cases to date within 6 weeks. All cultures revealed
Enterobacter cloacae. Happily no one implant had to be removed yet.
What could be most probable cause of the outbreak? The surgeries were
absolutely routine as well as all previous. Our epidemiologist found
nothing in the theatre, air, instruments... where to seek the
bacterial agent? If the source is not cleared, what preventive
measures could be performed to decrease the risk of infection? More
thorough hair removal? Change of antibiotic profilaxis program?
Anything more? THX!

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

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