Seed source in Bremen clinic apparently discovered

Bremer Klinikum: Disinfectant vending machine Source of multidrug-resistant germs?

06/09/2012

The occurrence of multidrug-resistant germs in the preemie ward at the Bremen-Mitte Hospital seems to be nearing completion. A vending machine for the production of disinfectant solutions is suspected as a possible source of the pathogens.

By the end of 2011, several preemies had been infected with multidrug-resistant germs at the Bremen-Mitte Hospital from the Klebsiella bacteria genus. Three of the infected preemies did not survive the disease. The preemie station was closed, disinfected and remodeled, but immediately after reopening the same multidrug-resistant germs were detected again in a preemie. Now hygiene experts come to the conclusion that possibly a machine for producing disinfectant solutions was the cause of the transmission of antibiotic-resistant intestinal bacteria.

Biofilm in the disinfectant vending machine
According to the clinic, genetic material of the Klebsiella bacteria was detected in the machine for preparing the disinfecting solution in the fresh water supply hose. This is "a possible source" for the infections of premature babies, explained the hygiene expert Prof. Martin Exner, on Friday in Bremen. As an external expert, the director of the Institute for Hygiene and Public Health of the University of Bonn, Prof. Exner, was called in to clarify the enigmatic germs in the center of Bremen-Mitte. Although it still needs to be investigated whether the discovered germs in the vending machine actually coincide genetically with the strain that has caused a stir for months, but the experts were confident that they had finally located the source of infection. However, the results of the investigation into the bacteria from the hose of the machine can only be expected in one to two weeks. Only then can one say with certainty to what extent the machine for the production of the disinfectant solution played a role in the fatal infections of the premature babies in the center of Bremen-Mitte.

Blobs of bacteria enter the disinfectant solution
The hygiene expert Prof. Exner explained that possibly whole lumps of bacteria from the hose for the supply of fresh water could reach the disinfectant solution and survive there. Presumably for years, a so-called biofilm has developed in the tube and created a milieu in which bacteria could reproduce well and survive for a very long time. However, the question remains how Klebsiella bacteria could even get into the tube, Exner continues. The extent to which the vending machine has now found the source of infection can not be said at present, but here a new "important point" was discovered, "which we have to investigate," emphasized the hygiene expert.

The health senator Renate Jürgens-Pieper (SPD) referred to the similarities between the previous occurrence of the infections and the possible processes described by Exner in the vending machine. "The tracks fit what's there for observation," emphasized Jürgens-Pieper. Sporadic detachment of bacterial clots is consistent with the sudden and massive onset of infection.

Multiresistant germs have long been a problem in the Bremen hospital
The experts explained that the Klebsiella strain, which has not yet been detected in Germany, was supposed to have been imported by a foreign child in 2009, when the resistant intestinal bacteria arrived in the clinic. In the spring of 2011 it was then for the first time come to a germ outbreak on the neonatal intensive care unit of the hospital. Subsequently, several premature babies became infected with multidrug-resistant bacteria and three of them died of the infection at the end of 2011. Several stations were closed, comprehensive hygiene measures were carried out and yet shortly after the reopening in early 2012, multi-drug resistant pathogens were again demonstrated. Again, two of the infected infants died, but there was no clear link between premature death and infection with the Klebsiella strain. Neonatology at Bremen-Mitte Hospital was finally closed by the Bremen Health Senator and a committee of inquiry was convened to investigate the infections with the multidrug-resistant pathogens.

Exchange he planned disinfectant vending machine
In order to prevent future infections with multidrug-resistant germs on the disinfectant vending machine, according to information from the Bremer health senator and the manager of the North Clinic, Jutta Dernedde, together with the new hospital hygienist of the Bremen-center, Martin Eikenberg, a plan of action for rehabilitation and Monitoring of all disinfectant dosing systems are created. In order to avoid health risks for the patients, "we have to initiate maintenance or exchange immediately", emphasized the manager of the hospital association. At the same time, those responsible promoted trust.

Hygiene expert Exner emphasized that important improvements would be implemented in the Bremen hospital. Moreover, infections caused by certain types of resistant bacteria are not a problem restricted to the Bremen-Mitte hospital but, in his opinion, will become a growing challenge throughout Germany in the future. Since the development of new antibiotics for the treatment of multidrug-resistant pathogens is not in sight, strict compliance with hygiene measures remains the only option to protect against the dangerous germs. (Fp)

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