Universität zu Köln

Paul, G., Meissner, A., Neuneier, J., Neuschmelting, V, Grau, S., Yagdiran, A., Scheyerer, M. J., Malin, J. J., Suarez, I, Lehmann, C., Exner, M., Wiesmuller, G. A., Higgins, P. G., Seifert, H., Fatkenheuer, G., Zweigner, J. and Jung, N. (2021). Outbreak of Pseudomonas aeruginosa infections after CT-guided spinal injections. J. Hosp. Infect., 116. S. 1 - 10. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2939

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Abstract

Background: Meningitis and spinal infections with Gram-negative bacteria after local injections for treatment of chronic back pain are rare. This study investigated an outbreak of Pseudomonas aeruginosa infections following computed tomography (CT)-guided spinal injections (SI). Methods: A case was defined as a spinal infection or meningitis with P. aeruginosa after SI between 10th January and 1st March 2019 in the same outpatient clinic. Patients without microbiological evidence of P. aeruginosa but with a favourable response to antimicrobial therapy active against P. aeruginosa were defined as probable cases. Findings: Twenty-eight of 297 patients receiving CT-guided SI during the study period developed meningitis or spinal infections. Medical records were available for 19 patients. In 15 patients, there was microbiological evidence of P. aeruginosa, and four patients were defined as probable cases. Two of 19 patients developed meningitis, while the remaining 17 patients developed spinal infections. The median time from SI to hospital admission was 8 days (interquartile range 2-23 days). Patients mainly presented with back pain (N=18; 95%), and rarely developed fever (N=3; 16%). Most patients required surgery (N=16; 84%). Seven patients (37%) relapsed and one patient died. Although the source of infection was not identified microbiologically, documented failures in asepsis when performing SI probably contributed to these infections. Conclusions: SI is generally considered safe, but non-adherence to asepsis can lead to deleterious effects. Spinal infections caused by P. aeruginosa are difficult to treat and have a high relapse rate. (C) 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Paul, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Neuneier, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Neuschmelting, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Yagdiran, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheyerer, M. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Malin, J. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Suarez, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Exner, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiesmuller, G. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Higgins, P. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fatkenheuer, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweigner, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jung, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-588435
DOI:	10.1016/j.jhin.2021.07.004
Journal or Publication Title:	J. Hosp. Infect.
Volume:	116
Page Range:	S. 1 - 10
Date:	2021
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-2939
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VERTEBRAL OSTEOMYELITIS; EPIDURAL INJECTION; STEROID INJECTION; SPONDYLODISCITIS; DIAGNOSIS; ABSCESSES; STENOSIS; LIFE; PAIN Multiple languages Public, Environmental & Occupational Health; Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58843