The Hopkins finding comes in response to the investigation of an outbreak of the antimicrobial resistant bacterium Acinetobacter baumannii at JHH during a two-month period in 2003. The organism infected 11 patients and was traced back to use of pulsatile lavage equipment for wound care. Three of these patients required admission to the intensive care unit for sepsis and respiratory distress.
In the future, staff using the water-gun like equipment will have to wear masks, gowns and gloves during procedures, which must also now be performed in private treatment rooms that are fully disinfected between patients to reduce the chances of cross contamination between patients and staff.
As an added response, the United States Food and Drug Administration (FDA), which supervises device safety, along with a leading manufacturer of the device have agreed to change the product's labeling to include use of routine infection control procedures.
Hopkins already has instituted the new infection control procedures.
"Changes at Hopkins and results of the study should change the way this common procedure is performed at other acute-care hospitals and long-term care facilities," said senior study investigator and hospital epidemiologist Trish Perl, M.D., an associate professor of medicine and pathology at The Johns Hopkins University School of Medicine.
The Hopkins case study is believed to be the first investigation to relate an outbreak of this bacterium to the pulsatile lavage device, and its results are to be published in the latest edition of the Journal of the American Medical Association online Dec. 22.