An outbreak of Pseudomonas aeruginosa urinary tract infections following cystoscopy traceable to a malfunctioning drying cabinet.

Background: Pseudomonas aeruginosa is an important bacterial pathogen, particularly as a cause of nosocomial infections in hospitalized patients. Only few reports exist in which cystoscopes were implicated as an outbreak source. We describe an investigation into the cause of a sudden increase in the number of urinary tract infections (UTI) with P. aeruginosa in patients after cystoscopy. In addition, we share the lessons learned and measures taken to reduce the risk of similar infections in the future. Presentation of Case: Over a period of two weeks the urology outpatient department noticed a UTI in four patients following cystoscopy. An investigation was started for a common source of the outbreak in the urological treatment room. Additional screening of patients revealed a total of eleven males with P. aeruginosa UTI following cystoscopy. The infections were found to be due to a defective drying cabinet, which lacked an alarm signaling in case of loss of airflow. Amplified fragment length polymorphism (AFLP) analysis revealed that P. aeruginosa isolates from three patients and six isolates from environmental cultures (including cystoscopes from the drying cabinet) genotypically belonged to one strain. Discussion: The AFLP results suggest that contaminated cystoscopes caused P. aeruginosa UTI in 11 patients, with the drying cabinet as site of transfer of the infective strain. To our knowledge, this is the first report describing a malfunctioning drying cabinet as source of an outbreak following cystoscopy. Conclusion: In case of concomitant P. aeruginosa infections, cystoscopes and drying cabinets should be suspected as a potential source. Molecular techniques are helpful in investigating the epidemiology of an outbreak.

Supplementing SARS-CoV-2 genomic surveillance with PCR-based variant detection for real-time actionable information, the Netherlands, June to July 2021.

We evaluated routine testing with SARS-CoV-2 Delta variant-specific RT-PCR in regional hospital laboratories in addition to centralised national genomic surveillance in the Netherlands during June and July 2021. The increase of the Delta variant detected by RT-PCR correlated well with data from genomic surveillance and was available ca 2 weeks earlier. This rapid identification of the relative abundance and increase of SARS-CoV-2 variants of concern may have important benefits for implementation of local public health measures.

[A new form of Kaposi sarcoma]. / Een nieuwe vorm van het kaposisarcoom.

BACKGROUND: Kaposi sarcoma is an vascular neoplasm caused by infection with human herpesvirus-8. Known risk groups are Mediterranean, eastern European Jewish and African ancestry men or men with AIDS. Nowadays we distinguish more subgroups. CASE DESCRIPTION: We present a healthy 39 year old man with a lesion on the right foot, having homosexual contacts, without HIV infection. Previous histology revealed signs of hemangioma. Recent clinical signs and histology confirmed multifocal Kaposi sarcoma. He was treated with radiotherapy. We also present a 65 year old MSM with and a lesion on the sole of the foot. Histology revealed for a solitary nodular Kaposi sarcoma. A short term relapse after surgical excision occurred. CONCLUSION: Kaposi sarcoma is subdivided into different categories. Kaposi Sarcoma in HIV-negative MSM is seen more frequently today, yet usually shows an indolent course. An adjusted less aggressive treatment and follow-up is therefore justified.