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Improper epidural procedures linked to MSSA cases at pain clinic
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ATLANTA — Irregular implementation of safety procedures and infection control methods during epidural injections likely led to an outbreak of methicillin-susceptible Staphylococcus aureus, according to data presented here at the 59th Annual Epidemic Intelligence Service Conference.
Rachel A. Radcliffe, DVM, MPH, of the CDC, and colleagues conducted a cohort study of patients who were administered injections from April 27 to May 13, 2009 at an outpatient pain clinic in West Virginia after three patients who were administered epidural injections were hospitalized with MSSA.
The researchers confirmed MSSA infection with cultures from blood, cerebrospinal fluid or epidural abscess. Patients were considered “probable” if clinical signs of infection, such as fever or leukocytosis, appeared within 14 days after injection.
The researchers identified eight cohort patients as cases — six were culture-confirmed, and the patients’ median age was 65 years, according to Radcliffe. Seven patients were hospitalized for bacteremia, epidural abscess or meningitis, but all survived. Additionally, the researchers observed no association between medications or underlying conditions and case status.
The researchers also noted that one employee performed all epidural injections. Staff use of face masks was inconsistent; skin preparations for patients were suboptimal and syringes used for epidural injections were reused when accessing shared medication vials, the researchers reported.
This investigation indicated that adhering to proper infection control measures in all health care settings is important in protecting patient safety and health, according to the researchers. — by Melissa Foster
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