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Sepsis outbreak identified at LA dialysis center

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Improper cleaning and disinfection of artificial kidneys led to three patients with chronic kidney failure to contract sepsis, according to data from a poster presented at the 39th Annual Educational Conference and International Meeting of the Association for Professionals in Infection Control.

Researchers from the County of Los Angeles Department of Public Health conducted an epidemiologic and environmental investigation of the dialysis center in August 2011, when they were notified that five patients from the center were diagnosed with bacteremia. Cases were defined as dialysis patients in the center who tested positive for Stenotrophomonas maltophilia.

There were four cases, and in three of the patients, the bacteria were genetically linked. Two of these patients were also positive for Candida parapsilosis. One patient was positive for C. parapsilosis in the artificial kidney only. One patient was positive in the blood and in the artificial kidney. These were genetically traced to the same fungus in a faucet in the reprocessing room, where the artificial kidneys are disinfected and sanitized.

L’Tanya English

During the investigation, the researchers found that all cases used an artificial kidney with a removable component — an O-ring header — and they were the only patients to use this type of artificial kidney. The facility, therefore, discontinued multi-use artificial kidneys with O-ring headers.

“Hemodialysis technology is life-saving, but carries a high risk for infection, regardless of the type of [artificial kidney] used,” L’Tanya English, RN, MPH, of the County of Los Angeles Department of Public Health, said in a press release. “Dialysis centers must work to reduce the risk for infection among their patients by ensuring proper cleaning and disinfection procedures are being followed throughout the facility. If multi-use [artificial kidneys] with removable headers and O-rings are used, processes to ensure proper disinfection must be in place.”

References:

English L. #9-136. Presented at: 39th Annual Educational Conference and International Meeting of the Association for Professionals in Infection Control; Jun 4-6, 2012; San Antonio.

Disclosures:

Ms. English reports no relevant financial disclosures.