Detection and analysis of an Achromobacter xylosoxidans outbreak in a urodynamics unit.

Abstract

Introduction: Achromobacter xylosoxidans is a gramnegative bacillus resistant to multiple antibiotics, present both in the environment and in hospitals. This study describes an outbreak of colonizations and infections by A. xylosoxidans in the urodynamics unit of the Puigvert Foundation.

Methods: On November 11, 2022, a patient developed a fever, and A. xylosoxidans was detected in their urine and blood. The case was linked to a recent urodynamic study. As a result, all A. xylosoxidans cases since 2018 were reviewed, and inspections were conducted in the unit, along with the collection of 24 environmental samples.

Results: The review identified 21 patients with A. xylosoxidans infections after urodynamic procedures since April 2022. Environmental microbiological controls revealed that pressure transducers were the likely source of infection. Corrective measures included the temporary closure of the unit, thorough cleaning with hypochlorite, use of single-use urinary catheters, daily replacement of equipment lines and pressure transducers, as well as other improvements in disinfection, handling, and workflows. A multidisciplinary team was formed to implement and supervise these actions.

Conclusions: The measures resulted in the elimination of the outbreak and the safe resumption of activities in the unit. This incident highlights the importance of continuous surveillance and rapid response in clinical settings to prevent infections and improve patient safety.