Outbreak of Pseudomonas aeruginosa infections after CT-guided spinal injections.

Anti-Bacterial Agents / therapeutic use Disease Outbreaks Humans Injections, Spinal Pseudomonas Infections / drug therapy Pseudomonas aeruginosa Tomography, X-Ray Computed
Meningitis Outbreak Pseudomonas aeruginosa Spinal injection Vertebral osteomyelitis

Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
Oct 2021
Historique:
received: 17 04 2021
revised: 06 07 2021
accepted: 07 07 2021
pubmed: 24 7 2021
medline: 6 10 2021
entrez: 23 7 2021
Statut: ppublish

Résumé

Meningitis and spinal infections with Gram-negative bacteria after local injections for treatment of chronic back pain are rare. This study investigated an outbreak of Pseudomonas aeruginosa infections following computed tomography (CT)-guided spinal injections (SI). A case was defined as a spinal infection or meningitis with P. aeruginosa after SI between 10 Twenty-eight of 297 patients receiving CT-guided SI during the study period developed meningitis or spinal infections. Medical records were available for 19 patients. In 15 patients, there was microbiological evidence of P. aeruginosa, and four patients were defined as probable cases. Two of 19 patients developed meningitis, while the remaining 17 patients developed spinal infections. The median time from SI to hospital admission was 8 days (interquartile range 2-23 days). Patients mainly presented with back pain (N=18; 95%), and rarely developed fever (N=3; 16%). Most patients required surgery (N=16; 84%). Seven patients (37%) relapsed and one patient died. Although the source of infection was not identified microbiologically, documented failures in asepsis when performing SI probably contributed to these infections. SI is generally considered safe, but non-adherence to asepsis can lead to deleterious effects. Spinal infections caused by P. aeruginosa are difficult to treat and have a high relapse rate.

Sections du résumé

BACKGROUND BACKGROUND
Meningitis and spinal infections with Gram-negative bacteria after local injections for treatment of chronic back pain are rare. This study investigated an outbreak of Pseudomonas aeruginosa infections following computed tomography (CT)-guided spinal injections (SI).
METHODS METHODS
A case was defined as a spinal infection or meningitis with P. aeruginosa after SI between 10
FINDINGS RESULTS
Twenty-eight of 297 patients receiving CT-guided SI during the study period developed meningitis or spinal infections. Medical records were available for 19 patients. In 15 patients, there was microbiological evidence of P. aeruginosa, and four patients were defined as probable cases. Two of 19 patients developed meningitis, while the remaining 17 patients developed spinal infections. The median time from SI to hospital admission was 8 days (interquartile range 2-23 days). Patients mainly presented with back pain (N=18; 95%), and rarely developed fever (N=3; 16%). Most patients required surgery (N=16; 84%). Seven patients (37%) relapsed and one patient died. Although the source of infection was not identified microbiologically, documented failures in asepsis when performing SI probably contributed to these infections.
CONCLUSIONS CONCLUSIONS
SI is generally considered safe, but non-adherence to asepsis can lead to deleterious effects. Spinal infections caused by P. aeruginosa are difficult to treat and have a high relapse rate.

Identifiants

DOI: 10.1016/j.jhin.2021.07.004 PMID: 34298033
pubmed: 34298033
pii: S0195-6701(21)00265-6
doi: 10.1016/j.jhin.2021.07.004
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-9

Informations de copyright

Copyright © 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Auteurs

G Paul (G)

Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Gastroenterology, Hepatology, Pneumology and Infectious Diseases, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany. Electronic address: gregor.paul@uk-koeln.de.

A Meißner (A)

Department of Hospital Hygiene and Infection Control, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

J Neuneier (J)

Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

V Neuschmelting (V)

Centre for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

S Grau (S)

Centre for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

A Yagdiran (A)

Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

M J Scheyerer (MJ)

Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

J J Malin (JJ)

Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany.

I Suárez (I)

Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany.

C Lehmann (C)

Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany.

M Exner (M)

Institute of Hygiene and Public Health, Bonn University, Bonn, Germany.

G A Wiesmüller (GA)

Abteilung Infektions- and Umwelthygiene, Gesundheitsamt der Stadt Köln, Germany.

P G Higgins (PG)

Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany.

H Seifert (H)

Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany.

G Fätkenheuer (G)

Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany.

J Zweigner (J)

Department of Hospital Hygiene and Infection Control, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

N Jung (N)

Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

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Classifications MeSH

Recherchemedicale.com › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Outbreak of Pseudomonas aeruginosa infections...
Recherchemedicale.com › Environnement et santé publique › Santé publique › Épidémies de maladies › Outbreak of Pseudomonas aeruginosa infections...
Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Outbreak of Pseudomonas aeruginosa infections...
Recherchemedicale.com › Thérapeutique › Traitement médicamenteux › Voies d'administration de substances chimiques et des médicaments › Injections › Injections rachidiennes › Outbreak of Pseudomonas aeruginosa infections...
Recherchemedicale.com › Infection › Infections bactériennes et mycoses › Infections bactériennes › Infections bactériennes à Gram négatif › Infections à Pseudomonas › Outbreak of Pseudomonas aeruginosa infections...
Recherchemedicale.com › Bactéries › Proteobacteria › Gammaproteobacteria › Pseudomonadaceae › Pseudomonas › Pseudomonas aeruginosa › Outbreak of Pseudomonas aeruginosa infections...
Recherchemedicale.com › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Tomographie à rayons X › Tomodensitométrie › Outbreak of Pseudomonas aeruginosa infections...