RESUMO
We report the successful control of an outbreak of six cases of nosocomial invasive aspergillosis (IA) in our haematology unit coinciding with major hospital construction works. Infection control changes included unit relocation, impermeable barriers at construction site, face-masking and voriconazole prophylaxis of 18 further high-risk patients, none of which developed breakthrough IA. A multi-faceted pre-emptive approach involving clinicians, hospital management, engineering and building departments is essential in preventing nosocomial IA outbreaks.
Assuntos
Aspergilose/prevenção & controle , Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Arquitetura Hospitalar , Controle de Infecções/métodos , Antifúngicos/uso terapêutico , Aspergilose/epidemiologia , Quimioprevenção , Infecção Hospitalar/epidemiologia , Exposição Ambiental/prevenção & controle , Hematologia , Unidades Hospitalares , Humanos , Pirimidinas/uso terapêutico , Triazóis/uso terapêutico , VoriconazolRESUMO
We describe an outbreak of multi-drug-resistant Acinetobacter baumannii (MRAB) that occurred in an intensive care unit (ICU) and a surgical ward from December 2003 to March 2004. Mapping patient movements on a timeline indicated that the outbreak was confined to these two areas. Investigation by the hospital's infection prevention service found that a possible source of spread was improper cleaning methods used on respiratory equipment. Pulsed-field gel electrophoresis analysis of available isolates indicated the presence of two distinct strains. One strain was seen in patients from the ICU and the other strain was seen in the surgical ward patients. Cleaning and environmental decontamination as well as staff education were implemented to halt further immediate spread. The deficiencies identified during the investigation were also resolved. The final outcome was the successful termination of this outbreak.