A Hepatitis C virus (HCV) outbreak associated with an independent pain management clinic was identified in Los Angeles County, prompting a public health investigation to identify the outbreak source, associated HCV cases and prevent further infections. While a specific source of HCV transmission was unable to be identified, evidence supports the possibility that a multidose medication vial was contaminated by reuse of a needle or syringe and may have contributed to the outbreak.
An outbreak of CRAB was detected in nine patients across three wards at a tertiary-care hospital, prompting infection prevention measures and targeted screening. The cases reflected ongoing community transmission from high-risk facilities and highlighted the necessity of a robust surveillance system and mitigation efforts.
Outbreaks involving duodenoscopes have been gaining attention across the healthcare field, broader community, and lay press. Their complex design may contribute to high risk of infection, and other types of endoscopes are also frequently implicated in outbreak investigations. This podcast episode discusses bronchoscopy-associated outbreaks and pseudo-outbreaks, as demonstrated in a recently published study in ICHE, and how listeners can identify these events and key prevention strategies to reduce risk of such outbreaks and pseudo-outbreaks.
Despite adhering to cleaning and disinfection strategies meeting or exceeding manufacturer’s instructions for use, various water-based heater-cooler devices have been implicated in nontuberculous mycobacteria (NTM) outbreaks. Ongoing rigorous surveillance for healthcare-associated NTM alerted investigators to a cluster of three extrapulmonary M. abscessus infections among patients who had undergone cardiothoracic surgery. This outbreak investigation highlighted the need for additional heater-cooler device design modifications to better contain aerosols or filter exhaust during device operation to prevent NTM transmission.
This editorial by CORHA’s SHEA representatives describes how whole-genome sequencing (WGS) surveillance is making significant strides in healthcare outbreak detection and response, as exemplified by a recent report from researchers in Australia. The potential for this technology to result in cost savings and healthcare-associated infection (HAI) reduction is promising; the authors call for actions to help compel further investment in WGS surveillance as a new standard in infection prevention and control.
Whole-genome sequencing (WGS) is increasingly used to characterize hospital outbreaks of cabapenemase-producing Enterobacterales (CPE); however, access to WGS is variable and testing is often associated with reporting delays. An eight-year study conducted at a hospital in Sydney, Australia, demonstrated the importance of embedding WGS in routine surveillance with results reported in real time. The authors described how their WGS approach identified 9 outbreaks and helped optimize local CPE control measures.
Noting similarities to a 2021 outbreak, clinicians diagnosed and promptly reported two tuberculosis (TB) cases among bone allograft recipients. The subsequent public health investigation confirmed a bone allograft-related outbreak affecting 36 recipients. This second outbreak of bone allograft-related TB in recent years underscores the urgency of implementing improved donor screening and culture-based testing to prevent tissue-derived Mycobacterium tuberculosis transmission.
Two outbreaks of genetically unrelated carbapenem-resistant New Delhi metallo- β-lactamase-producing Escherichia coli were caused by contaminated duodenoscopes. The occurrence of these two outbreaks within a few months, despite improvements in HLD compliance, supports the research team’s hypothesis of contamination from inaccessible parts of the elevator channels. Using endoscopes with disposable end caps, adherence to the manufacturer’s reprocessing instructions, routine audits, and manufacturer evaluation are critical in preventing such outbreaks.
A retrospective case series found that an outbreak of Staphylococcus epidermidis after immediate sequential bilateral cataract surgery (ISBCS) at a community-based eye clinic was likely due to a systemic breach of sterility. The same strain of bacteria was detected in all cultures of three consecutive patients who presented with bilateral simultaneous postoperative endophthalmitis (BSPOE) after undergoing ISBCS on the same day at the same clinic in Denmark. The outbreak highlighted the importance of strict adherence to guideline-recommended precautions for safe ISBCS.
Fruit cup products were implicated in an outbreak of salmonellosis in two hospitals. Investigators encountered several challenges related to control selection, small sample sizes, missing data, and differences in operations between facilities. The researchers are featured in the latest episode of the American Journal of Infection Control’s podcast, Science Into Practice, where they discuss lessons learned and share insights related to communication between hospitals and health departments and other aspects of healthcare-related foodborne outbreaks.