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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
Outbreak of Bacillus cereus Pseudobacteremia Linked to Contaminated Washcloths |
| Language |
J |
| AuthorList |
Yoshio Izawa1), Makoto Ito2) |
| Affiliation |
1) Divisions of Clinical Microbiology
2) Infection Control and Epidemiology, Department of Pathology and Laboratory Medicine, Toyota Medical Corporation, Kariya General Hospital, 5-15 Sumiyoshi, Kariya, Aichi 448-8505, Japan |
| Publication |
J.J.C.M.: 15 (2), 82-89, 2005 |
| Received |
August 23, 2004 |
| Accepted |
April 25, 2005 |
| Abstract |
During the summer and autumn seasons of 2002 in an acute-care tertiary hospital, an outbreak of pseudobacteremia caused by Bacillus cereus occurred in chronically ill patients with an indwelling peripheral venous catheter. The source of Bacillus contamination was examined by analyzing extensive surveillance cultures of the patient's skin, fabrics, medical equipment, and environmental surfaces. An unexpectedly high level of B. cereus contamination was identified in washcloths that were routinely used in nursing practices, such as backrubs, towel baths, and perineal care. The laundry of washcloths was outsourced. Clean, dry washcloths that were supplied following washing and sodium hydrochloride disinfection, were then soaked in water and heated in a steam bath at 65-70C° in the hospital ward before being used for care. Under these conditions, we consistantly found 103-104 CFU/ml of Bacillus species in the freshly prepared washcloths. Up to 106 CFU/ml of contaminating microorganisms could be recovered from washcloths stored at ambient temperature for more than 72 hours. It was postulated that the Bacillus cereus present in these washcloths might be transferred to the patient's skin during sanitary care, which would then cause contamination of blood culture specimens following needle sticks. Spore-forming Bacillus species that are naturally resistant to ethanol-based antiseptics may comprise the majority of B. cereus found in hospital environments. Thus, the polices and procedures for washcloths were revised to include steam heating beyond 85C° for 60 minutes and prohibition of prolonged storage in a wet state. These control measures were effective and substantially reduced the occurrence of pseudobacteremia due to Bacillus species. In conclusion, caregivers should be aware that washcloths may become contaminated with environmental spore-forming bacteria such as nonpathogenic Bacillus species. |
| Keywords |
Bacillus cereus |
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