Academic Journal
Pacemaker pocket infection due to environmental mycobacteria: Successful management of an outbreak and steps for prevention in future
| Title: | Pacemaker pocket infection due to environmental mycobacteria: Successful management of an outbreak and steps for prevention in future |
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| Authors: | Vijaya Bharat, Vivek Hittinahalli, Meenakshi Mishra, Sridhar Pradhan |
| Source: | Indian Heart Journal, Vol 68, Iss 1, Pp 63-67 (2016) |
| Publisher Information: | Elsevier, 2016. |
| Publication Year: | 2016 |
| Collection: | LCC:Surgery LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: | Pacemaker pocket infection, Environmental mycobacteria, Outbreak of SSI, Quality improvement project, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| More Details: | Background: An outbreak of surgical site infection (SSI) due to environmental mycobacteria (EMB) occurred in a hospital in Eastern India. Method: A quality improvement project (QIP) was undertaken to analyze the causes and prevent further outbreak. Step (1) Proof of the need: Four patients who had undergone pacemaker implantation consecutively during a 10-day period developed SSI. Step (2) Diagnostic journey: Since all patients developed SSI within 2 months of implantation, a common source of infection was likely. Atypical mycobacteria (AMB) were grown from surgical sites as well as from the surface of operation table, image intensifier, and lead aprons. It was a rapid growing variety that lacked pigment, a characteristic of EMB with pathogenic potential. The EMB was finally traced to its source, the overhead water tank. Step (3) Remedial journey: By thorough cleaning of the water tank and enriching its chlorine content, the EMB was eliminated from its source. Step (4) Holding the gains: Protocol for cleaning the water tank once in 3 months was made. A checklist was prepared to ensure compliance to asepsis protocol in the operation theater. In the ensuing 5 years, the infection did not recur. Result: The bacteria that caused SSI were identified as EMB that grew in the water tank and contaminated the operation room. It could be eliminated by appropriate measures. Interpretation: Water is a potential reservoir for EMB. Use of the term ‘environmental mycobacteria’ instead of ‘atypical mycobacteria’ will generate awareness about contamination as the cause of SSI. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 0019-4832 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S0019483215002497; https://doaj.org/toc/0019-4832 |
| DOI: | 10.1016/j.ihj.2015.06.023 |
| Access URL: | https://doaj.org/article/48efe0a353914ccb92113b9607524b31 |
| Accession Number: | edsdoj.48efe0a353914ccb92113b9607524b31 |
| Database: | Directory of Open Access Journals |
| ISSN: | 00194832 |
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| DOI: | 10.1016/j.ihj.2015.06.023 |
| Published in: | Indian Heart Journal |
| Language: | English |