- •A cluster of Delftia acidovorans infections occurred at a hemodialysis facility.
- •Delftia acidovorans was recovered from a wall box where 2 patients had been dialyzed.
- •Splashing of spent dialysate at wall boxes may have contaminated hands of personnel.
- •Contaminated saline prime bucket handles may also have been a source of infection.
- •Wall boxes should be disinfected at least daily, at the end of the day.
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to American Journal of Infection Control
- 2020 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kindey Diseases.Bethesda, MD, 2020
- National Healthcare Safety Network (NHSN) dialysis event surveillance report for 2014.Clin J Am Soc Nephrol. 2017; 12: 1139-1146
- Outbreak of gram-negative bacteremia and pyrogenic reactions in a hemodialysis center.Am J Nephrol. 1990; 10: 397-403
- Outbreak of pyrogenic reactions and gram-negative bacteremia in a hemodialysis center.Am J Nephrol. 1994; 14: 85-89
- Hemodialysis and water quality.Semin.Dial. 2013; 26: 427-438
- An outbreak of gram-negative bacteremia traced to contaminated O-rings in reprocessed dialyzers.Ann Intern Med. 1993; 119: 1072-1078
- An outbreak of gram-negative bloodstream infections in chronic hemodialysis patients.Am J Nephrol. 1995; 15: 1-4
- Outbreak of bloodstream infections associated with multiuse dialyzers containing O-rings.Infect Control Hosp Epidemiol. 2014; 35: 89-91
- Hemodialyzer reuse and gram-negative bloodstream infections.Am J Kid Dis. 2017; 69: 726-733
- Serratia liquefaciens bloodstream infections from contamination of epoetin alfa at a hemodialysis center.N Engl J Med. 2001; 344: 1491-1497
- Molecular epidemiology of a hepatitis C virus epidemic in a haemodialysis unit: outbreak investigation and infection outcome.BMC Infect Dis. 2010; 10: 257
- An outbreak of bloodstream infections arising from hemodialysis equipment.J Infect Dis. 1998; 178: 783-791
- Outbreak of bloodstream infections associated with dialysis machine waste ports in a hemodialysis facility.Eur J Clin Microbiol Infect Dis. 1999; 18: 723-725
- Elimination of an outbreak of gram-negative bacteremia in a hemodialysis unit.Am J Infect Control. 1996; 24: 359-363
- A cluster of bloodstream infections and pyrogenic reactions among hemodialysis patients traced to dialysis machine waste-handling option units.Am J Nephrol. 1998; 18: 485-489
- An outbreak of gram-negative bacteremia in hemodialysis patients traced to hemodialysis machine waste drain ports.Infect Control Hosp Epidemiol. 1999; 20: 746-751
- Clustered bacteremias in a hemodialysis unit: cross-contamination of blood tubing from ultrafiltrate waste.Infect Control Hosp Epidemiol. 1992; 13: 160-164
- Multicenter outbreak of gram-negative bloodstream infections in hemodialysis patients.Am J Kid Dis. 2019; 74: 610-619
- Recurrent intravascular-catheter-related bacteremia caused by Delftia acidovorans in a hemodialysis patient.J Clin Microbiol. 2011; 49: 3418-3421
- Standard Methods for the Examination of Water and Wastewater.23rd ed. American Public Health Association; American Water Works Association; Water Environment Federation, Washington, DC2017 (Vol)
Centers for Disease Control and Prevention. 2016 Update to the 2001 Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients. In: Centers for Disease C, Prevention, eds. 2016.
- Hepatitis C virus transmission in hemodialysis units: importance of infection control practices and aseptic technique.Infect Control Hosp Epidemiol. 2009; 30: 900-903
- Patient-care practices associated with an increased prevalence of hepatitis C virus infection among chronic hemodialysis patients.Infect Control Hosp Epidemiol. 2011; 32: 415-424
- A large outbreak of hepatitis C virus infections in a hemodialysis clinic.Infect Control Hosp Epidemiol. 2016; 37: 125-133
- Delftia acidovorans pseudo- outbreak in portable reverse osmosis machines: Interventions to ensure safe and cost-effective hemodialysis.Am J Infect Control. 2020; 48: 304-308
- Microscopic and spectroscopic analyses of chlorhexidine tolerance in Delftia acidovorans biofilms.Antimicrob Agents Chemother. 2014; 58: 5673-5686
- Comamonas acidovorans contamination of dental unit waters.Lett Appl Microbiol. 1999; 29: 52-55
- A multi-center outbreak of Candida tropicalis bloodstream infections associated with contaminated hemodialysis machine prime buckets.Am J Infect Control. 2021; 49: 1008-1013
- An outbreak of bloodstream infections in an outpatient hemodialysis center.Infect Control Hosp Epidemiol. 2002; 23: 725-729
- Targeting zero infections in hemodialysis.Am J Kid Dis. 2019; 74: 583-585
Centers for Diseases Control and Prevention. Dialysis Safety. Dialysis wall boxes and drains. 2019. Accessed February 19, 2021. cdc.gov/dialysis/guidelines/wall-boxes.html..
Strott K. ESRD NCC healthcare-associated infection (HAI) Learning and Action Network (LAN) discovery event. 2016. Accessed February 19, 2021,esrdncc.org/contentassets/66b85eda5c1948ae463410f1b3f8f6/ncc-discovery-event_120816_final_508.pdf. 2020.
- To boldly go where few have been before: Infection control assessment and response in the outpatient dialysis setting.in: Annual Council of State and Territorial Epidemiologists meeting; June 6, 2017, Boise, ID2017
Hernandez jL, W.; Ridge, H. The North Carolina dialysis infection control assessment and response (ICAR) experience., 2018. Accessed February 19, 2021.network6.esrd.ipro.org/wp-content/uploads/sites/4/2016/06/ANNA-5-23-18-NC-SPICE-ICAR_Final.pdf.
Publication stageIn Press Journal Pre-Proof
Conflicts of interest: JMB is a consultant to, and has received travel support and spoken at conferences supported by Diversey and GOJO Industries. He is also a consultant to Sodexo Healthcare.