Trend Recognition for Unusual Pathogens in Clinical Specimens

Abstract

BackgroundRaoultella is primarily an environmental bacterium and is rarely identified as a soft tissue pathogen in humans. Further investigation is warranted when an increase is identified in multiple tissue specimens in a short time period of time. An increase in the number of tissue specimens identified with Raoultella species was observed during the months of July and August 2014.MethodsA look-back of Raoultella isolated from all clinical specimens from January through August 2014 was completed. Patient demographic information was organized on a detailed line list including collection date, location, collection time, specimen source, physician and date of result. Operating room procedures for collecting tissue specimens were directly observed. The microbiology department performed direct observations for processing tissue specimens from receipt to isolate identification. A case control study was developed to compare patients with negative tissue results.ResultsConclusionsThe investigation identified a pseudo-outbreak of Raoultella from a contaminated bottle of saline used in the laboratory to moisten tissue samples prior to plate inoculation. Trend recognition is vital to identify pseudo-outbreaks that can result in the unnecessary administration of antibiotics. BackgroundRaoultella is primarily an environmental bacterium and is rarely identified as a soft tissue pathogen in humans. Further investigation is warranted when an increase is identified in multiple tissue specimens in a short time period of time. An increase in the number of tissue specimens identified with Raoultella species was observed during the months of July and August 2014. Raoultella is primarily an environmental bacterium and is rarely identified as a soft tissue pathogen in humans. Further investigation is warranted when an increase is identified in multiple tissue specimens in a short time period of time. An increase in the number of tissue specimens identified with Raoultella species was observed during the months of July and August 2014. MethodsA look-back of Raoultella isolated from all clinical specimens from January through August 2014 was completed. Patient demographic information was organized on a detailed line list including collection date, location, collection time, specimen source, physician and date of result. Operating room procedures for collecting tissue specimens were directly observed. The microbiology department performed direct observations for processing tissue specimens from receipt to isolate identification. A case control study was developed to compare patients with negative tissue results. A look-back of Raoultella isolated from all clinical specimens from January through August 2014 was completed. Patient demographic information was organized on a detailed line list including collection date, location, collection time, specimen source, physician and date of result. Operating room procedures for collecting tissue specimens were directly observed. The microbiology department performed direct observations for processing tissue specimens from receipt to isolate identification. A case control study was developed to compare patients with negative tissue results. Results ConclusionsThe investigation identified a pseudo-outbreak of Raoultella from a contaminated bottle of saline used in the laboratory to moisten tissue samples prior to plate inoculation. Trend recognition is vital to identify pseudo-outbreaks that can result in the unnecessary administration of antibiotics. The investigation identified a pseudo-outbreak of Raoultella from a contaminated bottle of saline used in the laboratory to moisten tissue samples prior to plate inoculation. Trend recognition is vital to identify pseudo-outbreaks that can result in the unnecessary administration of antibiotics.