Skip to main content

Advertisement

SpringerLink
Log in

Bacillus cereus bacteremia outbreak due to contaminated hospital linens

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

We describe an outbreak of Bacillus cereus bacteremia that occurred at Jichi Medical University Hospital in 2006. This study aimed to identify the source of this outbreak and to implement appropriate control measures. We reviewed the charts of patients with blood cultures positive for B. cereus, and investigated B. cereus contamination within the hospital environment. Genetic relationships among B. cereus isolates were analyzed. Eleven patients developed B. cereus bacteremia between January and August 2006. The hospital linens and the washing machine were highly contaminated with B. cereus, which was also isolated from the intravenous fluid. All of the contaminated linens were autoclaved, the washing machine was cleaned with a detergent, and hand hygiene was promoted among the hospital staff. The number of patients per month that developed new B. cereus bacteremia rapidly decreased after implementing these measures. The source of this outbreak was B. cereus contamination of hospital linens, and B. cereus was transmitted from the linens to patients via catheter infection. Our findings demonstrated that bacterial contamination of hospital linens can cause nosocomial bacteremia. Thus, blood cultures that are positive for B. cereus should not be regarded as false positives in the clinical setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Logan NA (2005) Bacillus anthracis, Bacillus cereus, and other aerobic endospore-forming bacteria. In: Borriello SP, Murray PR, Funke G (eds) Topley & Wilson’s Microbiology & Microbial Infections, Bacteriology, vol 2, 10th edn. American Society for Microbiology, Washington, DC, pp 922–952

    Google Scholar 

  2. Drobniewski FA (1993) Bacillus cereus and related species. Clin Microbiol Rev 6:324–338

    CAS  PubMed  Google Scholar 

  3. Ihde DC, Armstrong D (1973) Clinical spectrum of infection due to Bacillus species. Am J Med 55:839–845

    Article  CAS  PubMed  Google Scholar 

  4. Tuazon CU, Murray HW, Levy C, Solny MN, Curtin JA, Sheagren JN (1979) Serious infections from Bacillus sp. JAMA 241:1137–1140

    Article  CAS  PubMed  Google Scholar 

  5. Bryce EA, Smith JA, Tweeddale M, Andruschak BJ, Maxwell MR (1993) Dissemination of Bacillus cereus in an intensive care unit. Infect Control Hosp Epidemiol 14:459–462

    Article  CAS  PubMed  Google Scholar 

  6. Gray J, George RH, Durbin GM, Ewer AK, Hocking MD, Morgan ME (1999) An outbreak of Bacillus cereus respiratory tract infections on a neonatal unit due to contaminated ventilator circuits. J Hosp Infect 41:19–22

    Article  CAS  PubMed  Google Scholar 

  7. Van Der Zwet WC, Parlevliet GA, Savelkoul PH, Stoof J, Kaiser AM, Van Furth AM, Vandenbroucke-Grauls CM (2000) Outbreak of Bacillus cereus infections in a neonatal intensive care unit traced to balloons used in manual ventilation. J Clin Microbiol 38:4131–4136

    Google Scholar 

  8. Briley RT, Teel JH, Forler JP (2001) Nontypical Bacillus cereus outbreak in a child care center. J Environ Health 63(9–11):21

    Google Scholar 

  9. Kalpoe JS, Hogenbirk K, van Maarseveen NM, Gesink-Van der Veer BJ, Kraakman ME, Maarleveld JJ, van der Reyden TJ, Dijkshoorn L, Bernards AT (2008) Dissemination of Bacillus cereus in a paediatric intensive care unit traced to insufficient disinfection of reusable ventilator air-flow sensors. J Hosp Infect 68:341–347

    Article  CAS  PubMed  Google Scholar 

  10. Lee CC, Lin WJ, Shih HI, Wu CJ, Chen PL, Lee HC, Lee NY, Chang CM, Wang LR, Ko WC (2007) Clinical significance of potential contaminants in blood cultures among patients in a medical center. J Microbiol Immunol Infect 40:438–444

    PubMed  Google Scholar 

  11. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM (1988) CDC definitions for nosocomial infections, 1988. Am J Infect Control 16:128–140

    Article  CAS  PubMed  Google Scholar 

  12. Mossel DA, Koopman MJ, Jongerius E (1967) Enumeration of Bacillus cereus in foods. Appl Microbiol 15:650–653

    CAS  PubMed  Google Scholar 

  13. Logan NA, Berkeley RC (1984) Identification of Bacillus strains using the API system. J Gen Microbiol 130:1871–1882

    CAS  PubMed  Google Scholar 

  14. Liu PY, Ke SC, Chen SL (1997) Use of pulsed-field gel electrophoresis to investigate a pseudo-outbreak of Bacillus cereus in a pediatric unit. J Clin Microbiol 35:1533–1535

    CAS  PubMed  Google Scholar 

  15. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B (1995) Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239

    CAS  PubMed  Google Scholar 

  16. Akiyama N, Mitani K, Tanaka Y, Hanazono Y, Motoi N, Zarkovic M, Tange T, Hirai H, Yazaki Y (1997) Fulminant septicemic syndrome of Bacillus cereus in a leukemic patient. Intern Med 36:221–226

    Article  CAS  PubMed  Google Scholar 

  17. Arnaout MK, Tamburro RF, Bodner SM, Sandlund JT, Rivera GK, Pui CH, Ribeiro RC (1999) Bacillus cereus causing fulminant sepsis and hemolysis in two patients with acute leukemia. J Pediatr Hematol/Oncol 21:431–435

    Article  CAS  Google Scholar 

  18. Orrett FA (2000) Fatal Bacillus cereus bacteremia in a patient with diabetes. J Natl Med Assoc 92:206–208

    CAS  PubMed  Google Scholar 

  19. Gaur AH, Patrick CC, McCullers JA, Flynn PM, Pearson TA, Razzouk BI, Thompson SJ, Shenep JL (2001) Bacillus cereus bacteremia and meningitis in immunocompromised children. Clin Infect Dis 32:1456–1462

    Article  CAS  PubMed  Google Scholar 

  20. Hilliard NJ, Schelonka RL, Waites KB (2003) Bacillus cereus bacteremia in a preterm neonate. J Clin Microbiol 41:3441–3444

    Article  PubMed  Google Scholar 

  21. John AB, Razak EA, Razak EE, Al-Naqeeb N, Dhar R (2007) Intractable Bacillus cereus bacteremia in a preterm neonate. J Trop Pediatr 53:131–132

    Article  PubMed  Google Scholar 

  22. Kiyomizu K, Yagi T, Yoshida H, Minami R, Tanimura A, Karasuno T, Hiraoka A (2008) Fulminant septicemia of Bacillus cereus resistant to carbapenem in a patient with biphenotypic acute leukemia. J Infect Chemother 14:361–367

    Article  PubMed  Google Scholar 

  23. Hernaiz C, Picardo A, Alos JI, Gomez-Garces JL (2003) Nosocomial bacteremia and catheter infection by Bacillus cereus in an immunocompetent patient. Clin Microbiol Infect 9:973–975

    Article  CAS  PubMed  Google Scholar 

  24. Srivaths PR, Rozans MK, Kelly E Jr, Venkateswaran L (2004) Bacillus cereus central line infection in an immunocompetent child with hemophilia. J Pediatr Hematol/Oncol 26:194–196

    Article  Google Scholar 

  25. Koch A, Arvand M (2005) Recurrent bacteraemia by 2 different Bacillus cereus strains related to 2 distinct central venous catheters. Scand J Infect Dis 37:772–774

    Article  PubMed  Google Scholar 

  26. Barrie D, Hoffman PN, Wilson JA, Kramer JM (1994) Contamination of hospital linen by Bacillus cereus. Epidemiol Infect 113:297–306

    Article  CAS  PubMed  Google Scholar 

  27. Ohsaki Y, Koyano S, Tachibana M, Shibukawa K, Kuroki M, Yoshida I, Ito Y (2007) Undetected Bacillus pseudo-outbreak after renovation work in a teaching hospital. J Infect 54:617–622

    Article  PubMed  Google Scholar 

  28. Barrie D, Wilson JA, Hoffman PN, Kramer JM (1992) Bacillus cereus meningitis in two neurosurgical patients: an investigation into the source of the organism. J Infect 25:291–297

    Article  CAS  PubMed  Google Scholar 

  29. Dohmae S, Okubo T, Higuchi W, Takano T, Isobe H, Baranovich T, Kobayashi S, Uchiyama M, Tanabe Y, Itoh M, Yamamoto T (2008) Bacillus cereus nosocomial infection from reused towel in Japan. J Hosp Infect 69:361–367

    Article  CAS  PubMed  Google Scholar 

  30. Sehulster L, Chinn RY, CDC, HICPAC (2003) Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 52:1–42

    PubMed  Google Scholar 

  31. Berger SA (1983) Pseudobacteremia due to contaminated alcohol swabs. J Clin Microbiol 18:974–975

    CAS  PubMed  Google Scholar 

  32. Boyce JM, Pittet D, Healthcare Infection Control Practices Advisory Committee, HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force (2002) Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 51:1–45

    PubMed  Google Scholar 

  33. Weber DJ, Sickbert-Bennett E, Gergen MF, Rutala WA (2003) Efficacy of selected hand hygiene agents used to remove Bacillus atrophaeus (a surrogate of Bacillus anthracis) from contaminated hands. JAMA 289:1274–1277

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by a Grant-in-Aid for Scientific Research (grant 19590519) from the Japan Society for the Promotion of Science.

Author information

Authors and Affiliations

  1. Department of Infection and Immunity, School of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    T. Sasahara, S. Hayashi, Y. Morisawa, A. Yoshimura & Y. Hirai

  2. Department of Nursing, School of Nursing and Rehabilitation Sciences, International University of Health and Welfare, Odawara, Kanagawa, 250-8588, Japan

    T. Sakihama

Authors
  1. T. Sasahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Hayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y. Morisawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Sakihama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Yoshimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y. Hirai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Hayashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sasahara, T., Hayashi, S., Morisawa, Y. et al. Bacillus cereus bacteremia outbreak due to contaminated hospital linens. Eur J Clin Microbiol Infect Dis 30, 219–226 (2011). https://doi.org/10.1007/s10096-010-1072-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-010-1072-2

Keywords

Search

Navigation