An Outbreak of Pseudomonas aeruginosa Infection in Coronary Artery Bypass Graft Patients Related to Endoscopic Vein Harvesting Equipment.

BACKGROUND: Pseudomonas aeruginosa outbreaks have been associated with hospital water systems and endoscopic equipment. Twelve post-Coronary Artery Bypass Graft (CABG) patients were infected with a clonal strain of Pseudomonas aeruginosa, from October 2016 to February 2017. We describe the outbreak, and our investigation into the outbreak. METHODS: Multiple series of environmental sampling, solution and water system sampling were conducted during the outbreak. Samples were also taken from all equipment used in the CABG procedures. Samples were cultured by routine methods. Any growth of Pseudomonas aeruginosa isolated from these samples were compared with cultures from the patients for clonal relationship by using Pulse-field gel electrophoresis (PFGE). RESULTS: Pseudomonas aeruginosa was isolated from four environment and equipment samples. Two were from the waste-traps of two separate sinks in the Cardiac Intensive Care Unit, one from a suction bottle in the operating theatre, and one from the conical tips used for Endoscopic Vein Harvesting (EVH). A clonal relationship of 100% similarity was found by PFGE between 12 patients and the conical tips used for EVH. CONCLUSION: Pseudomonas aeruginosa outbreaks can occur due to contaminated endoscopic vein harvesting equipment used in CABG due to poor sterilization methods and non-compliance to manufacturers recommendations. DISCLOSURES: All authors: No reported disclosures.