Korean J Nosocomial Infect Control.  1999 Dec;4(2):91-101.

An Outbreak of Enterobacter cloacae sepsis After Endoscopic retrograde cholangiopancreatography

• Hong SK
• Pai H
• Rho IH
• Choi DO
• Rheem I

Abstract

METHODS: We investigated and compared the epidemiologic characteristics of the E. cloacae isolation in the period of outbreak (April-June, 1998) with those in the control period (January-March, 1998). To identify the risk factors for E. cloacae sepsis, we retrospectively conducted a chart review for the patients who had E. cloacae sepsis during the period of outbreak. On the basis of these results, environmental culture was performed hospital wide.
RESULTS
Ten clinical isolates E. cloacae were recovered from the blood of ten patients from April to June. 1998. Seven out of 10 patients recieved ERCP procedure just before E. cloacae sepsis. Hence, we performed surveillance study in the endoscopy room before and after the procedure. The survey showed that distilled water which was used for washing the endoscopy was contaminated with E. cloacae, which was suspected to be the common source of this outbreak. Therefore, we changed distilled water into sterilized distilled water on washing the endoscopy. After this correction was performed, the incidence of ERCP-associated E. cloacae sepsis declined markedly (P<0.011).
CONCLUSION
We investigated an outbreak of ERCP-related E. cloacae sepsis and the outbreak was successfully controlled by removing the source of infection.

Keyword

Enterobacter cloacae; Sepsis; ERCP

MeSH Terms

Cholangiopancreatography, Endoscopic Retrograde*
Cloaca
Endoscopy
Enterobacter cloacae*
Enterobacter*
Humans
Incidence
Methods
Retrospective Studies
Risk Factors
Sepsis*
Water
Water