Martín Pérez Francisco José, Molina Rueda María José, Enríquez Maroto María Francisca, Guijosa Campos Pilar
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Virgen de las Nieves. UGC de Prevención, Promoción y Vigilancia de la Salud. Granada. España.
Unidad de Epidemiología, Distrito Sanitario Granada-Metropolitano. UGC de Prevención, Promoción y Vigilancia de la Salud. Granada. España.
Rev Esp Salud Publica. 2024 Sep 19;98:e202409052.
In July 2022, an outbreak of Raoultella ornithinolytica infection was detected in users of a hemodialysis center in Granada and central venous catheter (CVC) users. The aim of this study was to describe the development of the outbreak and the control measures implemented as well as to identify the risk factors that may have been related to its origin.
A study of a series of thirteen cases with positive blood culture for Raoultella ornithinolytica was conducted during July 2022. Two hypotheses were considered: direct transmission through contamination of the antiseptic product or cross-contamination through the hands of healthcare personnel. A descriptive data analysis was carried out, with the calculation of attack rates and attributable risk in the exposed group (CVC users).
The center performed dialysis on 117 patients. 36 patients had a CVC, and 81 had an arteriovenous fistula (AVF). The total number of infected cases was 13. The attack rate was 11.1%, being 36.1% in patients with CVC and 0% in patients with AVF. The symptoms occurred between 1 and 3 hours after the start of dialysis, except in three cases that occurred after receiving dialysis in other centers. Samples of water, liquids and antiseptics were negative.
An outbreak of Raoultella ornithinolytica bacteraemia is confirmed, due to possible cross-contamination in the CVC handling and antisepsis process. Possibly, the germ was carried by a container of alcoholic chlorhexidine that contaminated the catheter and caused bacteremia during the hemodialysis process.
2022年7月，在格拉纳达一家血液透析中心的使用者以及中心静脉导管（CVC）使用者中检测到解鸟氨酸拉乌尔菌感染暴发。本研究的目的是描述该暴发的发展过程及实施的控制措施，并确定可能与其起源相关的风险因素。
对2022年7月13例血培养解鸟氨酸拉乌尔菌呈阳性的病例进行了研究。考虑了两种假设：通过抗菌产品污染直接传播或通过医护人员的手交叉污染。进行了描述性数据分析，计算了暴露组（CVC使用者）的发病率和归因风险。
该中心为117例患者进行了透析。36例患者使用CVC，81例患者使用动静脉内瘘（AVF）。感染病例总数为13例。发病率为11.1%，CVC患者中为36.1%，AVF患者中为0%。症状在透析开始后1至3小时出现，但有3例在其他中心接受透析后出现。水、液体和防腐剂样本均为阴性。
确诊了解鸟氨酸拉乌尔菌菌血症暴发，原因可能是CVC处理和消毒过程中的交叉污染。可能是一瓶酒精洗必泰污染了导管，并在血液透析过程中导致菌血症。
