Infection control experts at The Johns Hopkins Hospital say tighter rules governing use of a hand-held, high-pressure, water-pumping tool to wash and clean wounds should be adopted to improve the safety of wound care.
The Hopkins finding comes in response to the investigation of an outbreak of the antimicrobial Lead researcher Lisa Maragakis, M.D., clinical fellow at The Johns Hopkins University School of Medicine, holds a pulsatile lavage device that is used to wash and clean wounds.
The organism infected 11 patients and was traced back to use of pulsatile lavage equipment for wound care.
In the future, staff using the water-gun like equipment will have to wear masks, gowns and gloves during procedures, which must also now be performed in private treatment rooms that are fully disinfected between patients to reduce the chances of cross contamination between patients and staff.
"Changes at Hopkins and results of the study should change the way this common procedure is performed at other acute-care hospitals and long-term care facilities," said senior study investigator and hospital epidemiologist Trish Perl, M.D., an associate professor of medicine and pathology at The Johns Hopkins University School of Medicine.
The Hopkins case study is believed to be the first investigation to relate an outbreak of this bacterium to the pulsatile lavage device, and its results are to be published in the latest edition of the Journal of the American Medical Association online Dec. 22.
The Hopkins investigative team traced the infection to the pulsatile lavage tool made by Bard-Davol Inc., and determined that the equipment sprayed the potentially dangerous bacteria into the air and onto surfaces in an open treatment room, with other patients nearby.
Specific samples, or isolates, of Acinetobacter were analyzed using pulsed-field gel electrophoresis, to determine and track the spread of the specific strain of the bacterium involved in the hospital outbreak.