ABSTRACT
An 11-year-old girl with metastatic neuroblastoma developed recurrent bacteremia during sustained neutropenia after autologous peripheral blood transplantation. All febrile episodes of bacteremia were caused by single Delftia acidovorans strain revealed by ERIC-PCR. This strain became resistant to broad-spectrum penicillins and cephalosporins through antibiotic treatments. Removal of the indwelling vascular catheter resulted in resolution of the infection. So far as we know, this is the first report of vascular catheter-related D. acidovorans bacteremia in Japan.
Subject(s)
Bacteremia/microbiology , Catheter-Related Infections/microbiology , Catheters, Indwelling/microbiology , Delftia acidovorans/drug effects , Gram-Negative Bacterial Infections/microbiology , Neuroblastoma/microbiology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Catheter-Related Infections/drug therapy , Child , DNA, Bacterial/analysis , Delftia acidovorans/genetics , Delftia acidovorans/isolation & purification , Drug Resistance, Bacterial , Female , Gram-Negative Bacterial Infections/drug therapy , Humans , Japan , Microbial Sensitivity Tests , Opportunistic Infections/drug therapy , Opportunistic Infections/microbiology , Peripheral Blood Stem Cell Transplantation , Polymerase Chain Reaction , RNA, Ribosomal, 16S/analysis , beta-Lactams/pharmacology , beta-Lactams/therapeutic useABSTRACT
BACKGROUND: The risk of transmission of occupational blood-borne infection is a serious problem for health care workers (HCWs) in Japan. Although the Japanese version of Exposure Prevention Information Network (EPINet) was introduced in 1997, no published data in the clinical setting have been available yet. OBJECTIVE: To examine the epidemiology of occupational sharps injuries of HCWs in a university hospital using EPINet and to analyze the trends and changes in epidemiologic characteristics of needlestick injuries in a detailed situation. METHODS: The HCWs were requested to report sharps injury incidents to the Infection Control Nurse when the incidents occurred. Those who were involved in the incidents were required to personally complete an EPINET form. RESULTS: A total of 259 cases of sharps injuries occurred during the 7-year period. Registered nurses accounted for 72.2% of the cases, constituting the largest group of the HCWs. The incidents occurred most frequently in the hospital wards. Thirty-three cases (55.9%) of the injuries with syringe-needle units occurred "after use before disposal," whereas 34 cases (73.9%) of the injuries with suture needles occurred "during use of device." More than half of the injuries with a winged steel needle occurred despite the protective mechanism. DISCUSSION: There was no apparent difference in the characteristics of the subjects compared with other reports. The circumstances of the injuries varied with the kinds of instruments. This fact may provide useful information for planning measures to sharps injuries. CONCLUSIONS: With the problem of underreporting aside, a detailed study, such as ours, comprising by job category and by kind of instrument or the like would provide more useful and effective information in terms of sharps injury prevention.
