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Krankenhaushygiene up2date 2008; 3(2): e1-e24
DOI: 10.1055/s-2008-1077343
Nosokomiale Infektionen

© Georg Thieme Verlag KG Stuttgart · New York

Nosokomiale Pseudoinfektionen und Pseudoepidemien

Roland  Schulze-Röbbecke
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Publication Date:
19 June 2008 (online)

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Kernaussagen

  • Eine Pseudoinfektion (PI) ist das Vorliegen eines für eine Infektion charakteristischen Befundes, obwohl diese Infektion bei der betroffenen Person in Wirklichkeit nicht vorhanden ist. Als Pseudoepidemie oder Pseudoausbruch (PA) wird eine tatsächliche Häufung nicht vorhandener Infektionen oder eine nicht vorhandene Häufung tatsächlicher Infektionen bezeichnet.

  • PI und PA werden oft nur schwer als solche erkannt und können als nosokomiale Infektionen und Ausbrüche fehlinterpretiert werden. Besonders groß ist dieses Risiko in der Bronchoskopie.

  • PI und PA stellen ein Problem dar, da sie unnötige Therapiemaßnahmen (insbesondere Antibiotikatherapie), unnötige Behandlungskomplikationen, unnötige Belastungen für die Patienten, unnötige Liegezeitverlängerungen und unnötige Kosten mit sich bringen können. Die Diagnose und Therapie tatsächlicher Erkrankungen kann durch PI und PA verzögert werden.

  • Häufige Ursache von PI und PA ist die Probenkontamination mit Mikroorganismen aus der Umgebung (z. B. Leitungswasser, Luft) oder anderen Patientenproben. Die Kontamination kann bei Entnahme, Transport oder Laborverarbeitung der Probe stattfinden. Andere Ursachen sind Probenverwechslung, Fehlidentifikation im Labor, Fehldiagnosen und Surveillance-Artefakte.

  • Bei der Aufklärung eines Ausbruchs ist zunächst die Frage zu klären, ob es sich um einen tatsächlichen Ausbruch oder um einen Pseudoausbruch handelt.

  • Außer bei Fehldiagnosen oder Surveillance-Artefakten beinhaltet die Aufklärung von PI und PA die Überprüfung des mikrobiologischen Untersuchungsgangs von der Probenahme bis zur Befundung im Labor.

  • Bei der Infektions-Surveillance ist oft Unkenntnis der endemischen Grundrate Ursache von PA. Zudem kann es durch eine Intensivierung der Diagnostik oder Surveillance zu PA kommen.

Literatur

  • 1 Weinstein R A, Stamm W E. Pseudoepidemics in hospital.  Lancet. 1977;  2 862-864
    Google Scholar
  • 2 Lee C C, Lin W J, Shih H I. et al . Clinical significance of potential contaminants in blood cultures among patients in a medical center.  J Microbiol Immunol Infect. 2007;  40 438-444
    Google Scholar
  • 3 Souvenir D, Anderson  Jr D E, Palpant S. et al . Blood cultures positive for coagulase-negative staphylococci: antisepsis, pseudobacteremia, and therapy of patients.  J Clin Microbiol. 1998;  36 1923-1926
    Google Scholar
  • 4 Little J R, Trovillion E, Fraser V. High frequency of pseudobacteremia at a university hospital.  Infect Control Hosp Epidemiol. 1997;  18 200-202
    Google Scholar
  • 5 Jumaa P A, Chattopadhyay B. Pseudobacteraemia.  J Hosp Infect. 1994;  27 167-177
    CrossrefGoogle Scholar
  • 6 Schifman R B. Phlebotomists at risk.  Mayo Clin Proc. 1998;  73 703-704
    Google Scholar
  • 7 Wurtz R, Demarais P, Trainor W. et al . Specimen contamination in mycobacteriology laboratory detected by pseudo-outbreak of multidrug-resistant tuberculosis: analysis by routine epidemiology and confirmation by molecular technique.  J Clin Microbiol. 1996;  34 1017-1019
    Google Scholar
  • 8 Bearman G, Vaamonde C, Larone D, Drusin L, Zuccotti G. Pseudo-outbreak of multidrug-resistant Mycobacterium tuberculosis associated with presumed laboratory processing contamination.  Infect Control Hosp Epidemiol. 2002;  23 620-622
    CrossrefGoogle Scholar
  • 9 Weinbaum C M, Bodnar U R, Schulte J. et al . Pseudo-outbreak of tuberculosis infection due to improper skin-test reading.  Clin Infect Dis. 1998;  26 1235-1236
    Google Scholar
  • 10 Wang H C, Liaw Y S, Yang P C, Kuo S H, Luh K T. A pseudoepidemic of Mycobacterium chelonae infection caused by contamination of a fibreoptic bronchoscope suction channel.  Eur Respir J. 1995;  8 1259-1262
    CrossrefGoogle Scholar
  • 11 Culver D A, Minai O A, Gordon S M, Mehta A C. Infection Control and Radiation Safety in the Bronchoscopy Suite. In: Wang KP, Mehta AC, Turner JF (Hrsg) Flexible Bronchoscopy, 2. Auflage. Boston; Blackwell Publishing 2003:
    Google Scholar
  • 12 Mehta A C, Prakash U BS, Garland R. et al . American College of Chest Physicians and American Association for Bronchology Consensus Statement: Prevention of flexible bronchoscopy-associated infection.  Chest. 2005;  128 1742-1755
    CrossrefGoogle Scholar
  • 13 Maki D G. Through a glass darkly. Nosocomial pseudoepidemics and pseudobacteremias.  Arch Intern Med. 1980;  140 26-28
    CrossrefGoogle Scholar
  • 14 Siebor E, Llanes C, Lafon I. et al . Presumed pseudobacteremia outbreak resulting from contamination of proportional disinfectant dispenser.  Eur J Clin Microbiol Infect Dis. 2006;  26 195-198
    Google Scholar
  • 15 Centers for Disease Control and Prevention . Outbreaks of pseudo-infection with Cyclospora and Cryptosporidium - Florida and New York City, 1995.  MMWR Morb Mortal Wkly Rep. 1995;  46 354-358
    Google Scholar
  • 16 Cunha B A. Pseudoinfections and pseudo-outbreaks. In: Mayhall GC (ed) Hospital Epidemiology and Infection Control, 3. Auflage. Philadelphia; Lippincott Williams and Wilkins 2004: 123-133
    Google Scholar
  • 17 Forman W, Axelrod P, St J ohn. et al . Investigation of a pseudo-outbreak of orthopedic infections caused by Pseudomonas aeruginosa.  Infect Control Hosp Epidemiol. 1994;  15 652-657
    Google Scholar
  • 18 Lalande V, Barbut F, Varnerot A. et al . Pseudo-outbreak of Mycobacterium gordonae associated with water from refrigerated fountains.  J Hosp Infect. 2001;  48 76-79
    CrossrefGoogle Scholar
  • 19 Arnow P M, Bakir M, Thompson K, Bova J L. Endemic contamination of clinical specimens by Mycobacterium gordonae.  Clin Infect Dis. 2000;  31 472-476
    CrossrefGoogle Scholar
  • 20 Tokars J I, McNeil M M, Tablan O C. et al . Mycobacterium gordonae pseudoinfection associated with a contaminated antimicrobial solution.  J Clin Microbiol. 1990;  28 2765-2769
    Google Scholar
  • 21 Young J D, Balagopal A, Reddy N S, Schlesinger L S. Differentiating colonization from infection can be difficult - nontuberculous mycobacterial infections: Diagnosis and treatment.  J Respir Dis. 2007;  28 7-18
    Google Scholar
  • 22 Segal-Maurer S, Kreiswirth B N, Burns J M. et al . Mycobacterium tuberculosis specimen contamination revisited: the role of laboratory environmental control in a pseudo-outbreak.  Infect Control Hosp Epidemiol. 1998;  19 101-105
    Google Scholar
  • 23 Doran T I, Parra E. False-positive and indeterminate human immunodeficiency virus test results in pregnant women.  Arch Fam Med. 2000;  9 924-929
    CrossrefGoogle Scholar
  • 24 Calfee D P, Kornblum J, Jenkins S G. Pseudo-outbreak of Bordetella bronchiseptica infection associated with contaminated rabbit blood used as a broth culture supplement.  Infect Control Hosp Epidemiol. 2007;  28 758-760
    CrossrefGoogle Scholar
  • 25 Wallace Jr R J, Brown B A, Griffith D E. Nosocomial outbreaks/pseudo-outbreaks due to nontuberculosis mycobacteria.  Annu Rev Microbiol. 1998;  52 453-490
    CrossrefPubMedGoogle Scholar
  • 26 Lai K K, Brown B A, Westerling J A, Fontecchio S A, Zhang Y, Wallace Jr R J. Long-term laboratory contamination by Mycobacterium abscessus resulting in two pseudo-outbreaks: recognition with use of random amplified polymorphic DNA (RAPD) polymerase chain reaction.  Clin Infect Dis. 1998;  27 169-175
    CrossrefGoogle Scholar
  • 27 Heard S, Lawrence S, Holmes B, Costas M. A pseudo-outbreak of Pseudomonas on a special care baby unit.  J Hosp Infect. 1990;  16 59-65
    CrossrefGoogle Scholar
  • 28 Spala G, Panagiotopoulos T, Mavroidi N. et al . A pseudo-outbreak of human A/H5N1 infections in Greece and its public health implications.  Euro Surveill. 2006;  11 263-267
    Google Scholar
  • 29 Regan C M, Syed Q, Mutton K, Wiratunga B. A pseudo community outbreak of legionnaires’ disease in Merseyside, implications for investigation of suspected clusters.  J Epidemiol Community Health. 2000;  54 766-769
    CrossrefGoogle Scholar
  • 30 Centers for Disease Control and Prevention . Enhanced detection of sporadic Escherichia coli O157:H7 infections - New Jersey, July 1994.  MMWR Morb Mortal Wkly Rep. 1995;  44 417-418
    Google Scholar
  • 31 Kusek J W. Nosocomial pseudoepidemics and pseudoinfections: an increasing problem.  Am J Infect Control. 1981;  9 70-75
    Google Scholar
  • 32 Ostrowsky B, Jarvis W R. Efficient management of outbreak infestigations. In: Wenzel RP (ed) Prevention and Control of Nosocomial Infections, 4th edition. Philadelphia; Lippincott Williams & Wilkins 2003: 500-523
    Google Scholar
  • 33 Freeman J, Rogers K, Roberts S. Pseudo-outbreak of Aspergillus keratitis following construction in an ophthalmology ward.  J Hosp Infect. 2007;  67 104-105
    CrossrefGoogle Scholar
  • 34 Laurel V L, Meier P A, Astorga A, Dolan D, Brockett R, Rinaldi M G. Pseudoepidemic of Aspergillus niger infections traced to specimen contamination in the microbiology laboratory.  J Clin Microbiol. 1999;  37 1612-1616
    Google Scholar
  • 35 Weems  Jr J J, Andremont A, Davis B J, Tancrede C H, Guiguet M, Padhye A A, Squinazi F, Martone W J. Pseudoepidemic of aspergillosis after development of pulmonary infiltrates in a group of bone marrow transplant patients.  J Clin Microbiol. 1987;  25 1459-1462
    Google Scholar
  • 36 Schleupner C J, Hamilton J R. A pseudoepidemic of pulmonary fungal infections related to fiberoptic bronchoscopy.  Infect Control. 1980;  1 38-42
    Google Scholar
  • 37 Grigis A, Farina C, Symoens F, Nolard N, Goglio A. Nosocomial pseudo-outbreak of Fusarium verticillioides associated with sterile plastic containers.  Infect Control Hosp Epidemiol. 2000;  21 50-52
    CrossrefGoogle Scholar
  • 38 O’Donnell K, Sutton D A, Rinaldi M G. et al . Genetic diversity of human pathogenic members of the Fusarium oxysporum complex inferred from multilocus DNA sequence data and amplified fragment length polymorphism analyses: evidence for the recent dispersion of a geographically widespread clonal lineage and nosocomial origin.  J Clin Microbiol. 2004;  42 5109-5120
    CrossrefGoogle Scholar
  • 39 Goldstein B, Abrutyn E. Pseudo-outbreak of Bacillus species: related to fibreoptic bronchoscopy.  J Hosp Infect. 1985;  6 194-200
    Google Scholar
  • 40 Morrell Jr R M, Wasilauskas B L. Tracking laboratory contamination by using a Bacillus cereus pseudoepidemic as an example.  J Clin Microbiol. 1992;  30 1469-1473
    Google Scholar
  • 41 Hsueh P R, Teng L J, Yang P C, Pan H L, Ho S W, Luh K T. Nosocomial pseudoepidemic caused by Bacillus cereus traced to contaminated ethyl alcohol from a liquor factory.  J Clin Microbiol. 1999;  37 2280-2284
    Google Scholar
  • 42 Richardson A J, Rothburn M M, Roberts C. Pseudo-outbreak of Bacillus species: related to fibreoptic bronchoscopy.  J Hosp Infect. 1986;  7 208-210
    CrossrefGoogle Scholar
  • 43 Liu P Y, Ke S C, Chen S L. Use of pulsed-field gel electrophoresis to investigate a pseudo-outbreak of Bacillus cereus in a pediatric unit.  J Clin Microbiol. 1997;  35 1533-1535
    Google Scholar
  • 44 York M K. Bacillus species pseudobacteremia traced to contaminated gloves used in collection of blood from patients with acquired immunodeficiency syndrome.  J Clin Microbiol. 1990;  28 2114-2116
    Google Scholar
  • 45 Lettau L A, Benjamin D, Cantrell H F, Potts D W, Boggs J M. Bacillus species pseudomeningitis.  Infect Control Hosp Epidemiol. 1988;  9 394-397
    Google Scholar
  • 46 Kniehl E, Becker A, Forster D H. Pseudo-outbreak of toxigenic Bacillus cereus isolated from stools of three patients with diarrhoea after oral administration of a probiotic medication.  J Hosp Infect. 2003;  55 33-38
    CrossrefGoogle Scholar
  • 47 Ristagno R L, Saravolatz L D. A pseudoepidemic of Legionella infections.  Chest. 1985;  88 466-467
    CrossrefGoogle Scholar
  • 48 Mitchell D H, Hicks L J, Chiew R, Montanaro J C, Chen S C. Pseudoepidemic of Legionella pneumophila serogroup 6 associated with contaminated bronchoscopes.  J Hosp Infect. 1997;  37 19-23
    CrossrefGoogle Scholar
  • 49 Cox R, deBorja K, Bach M C. A pseudo-outbreak of Mycobacterium chelonae infections related to bronchoscopy.  Infect Control Hosp Epidemiol. 1997;  18 136-137
    Google Scholar
  • 50 Kressel A B, Kidd F. Pseudo-outbreak of Mycobacterium chelonae and Methylobacterium mesophilicum caused by contamination of an automated endoscopy washer.  Infect Control Hosp Epidemiol. 2001;  22 414-418
    Google Scholar
  • 51 Sniadack D H, Ostroff S M, Karlix M A. et al . A nosocomial pseudo-outbreak of Mycobacterium xenopi due to a contaminated potable water supply: lessons in prevention.  Infect Control Hosp Epidemiol. 1993;  14 636-641
    CrossrefPubMedGoogle Scholar
  • 52 Verweij P E, Bijl D, Melchers W J, De Pauw B E, Meis J F, Hoogkamp-Korstanje J A, Voss A. Pseudo-outbreak of multiresistant Pseudomonas aeruginosa in a hematology unit.  Infect Control Hosp Epidemiol. 1997;  18 128-131
    Google Scholar
  • 53 Kolmos H J, Lerche A, Kristoffersen K, Rosdahl V T. Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy.  Scand J Infect Dis. 1994;  26 653-657
    CrossrefGoogle Scholar
  • 54 Corne P, Godreuil S, Jean-Pierre H. et al . Unusual implication of biopsy forceps in outbreaks of Pseudomonas aeruginosa infections and pseudo-infections related to bronchoscopy.  J Hosp Infect. 2005;  61 20-26
    CrossrefGoogle Scholar
  • 55 Carmeli Y, Eichelberger K, Soja D. et al . Failure of quality control measures to prevent reporting of false resistance to imipenem, resulting in a pseudo-outbreak of imipenem-resistant Pseudomonas aeruginosa.  J Clin Microbiol. 1998;  36 595-597
    Google Scholar
  • 56 Manzar S, Nair A K, Pai M G, Al-Khusaiby S M. Pseudo-outbreak of Burkholderia cepacia in a neonatal intensive care unit.  J Hosp Infect. 2004;  58 159-165
    CrossrefGoogle Scholar
  • 57 Smith D J, Harris A A. „Pseudo-pseudobacteremia”.  JAMA. 1982;  248 649
    CrossrefGoogle Scholar
  • 58 Verzijl A, Berretty P J, Erceg A, Krekels G A, Van den Brule A J, Boel C H. Een pseudo-uitbraak van keelgonorroe samenhangend met een fout-positieve PCR-uitslag.  Ned Tijdschr Geneeskd. 2007;  151 689-691
    Google Scholar
  • 59 Diederen B MW, Verhulst C, van’t Veen A, van Keulen P HJ, Kluytmans J AJW. Pseudo-outbreak of hepatitis B virus infection associated with contamination of a semiautomatic cap remover.  Infect Control Hosp Epidemiol. 2006;  27 1258-1260
    CrossrefGoogle Scholar
  • 60 Wheeler P W, Lancaster D, Kaiser A B. Bronchopulmonary crosscolonization and infection related to mycobacterial contamination of suction valves of bronchoscopes.  J Infect Dis. 1989;  159 954-958
    Google Scholar
  • 61 Noskin G A, Suriano T, Collins S, Sesler S, Peterson L R. Paenibacillus macerans pseudobacteremia resulting from contaminated blood culture bottles in a neonatal intensive care unit.  Am J Infect Control. 2001;  29 126-129
    CrossrefGoogle Scholar
  • 62 Ender P T, Durning S J, Woelk W K. et al . Pseudo-outbreak of methicillin-resistant Staphylococcus aureus.  Mayo Clin Proc. 1999;  74 885-889
    Google Scholar
  • 63 Molina-Cabrillana J, Santana-Reyes C, González-García A, Bordes-Benítez A, Horcajada I. Outbreak of Achromobacter xylosoxidans pseudobacteremia in a neonatal care unit related to contaminated chlorhexidine solution.  Eur J Clin Microbiol Infect Dis. 2007;  26 435-437
    CrossrefGoogle Scholar
  • 64 Centers for Disease Control and Prevention . Bronchoscopy-related infections and pseudoinfections - New York, 1996 and 1998.  MMWR Morb Mortal Wkly Rep. 1999;  48 557-560
    Google Scholar
  • 65 Lévy-Frébault V, David H L. Mycobacterium kansasii: contaminant du réseau d’eau potable d’un hôpital.  Rev Épidém Santé Publ. 1983;  31 11-20
    Google Scholar
  • 66 Zhang Q, Kennon R, Koza M A, Hulten K, Clarridge  3rd J E. Pseudoepidemic due to a unique strain of Mycobacterium szulgai: genotypic, phenotypic, and epidemiological analysis.  J Clin Microbiol. 2002;  40 1134-1139
    CrossrefGoogle Scholar
  • 67 Laussucq S, Baltch A L, Smith R P. et al . Nosocomial Mycobacterium fortuitum colonization from a contaminated ice machine.  Am Rev Respir Dis. 1988;  138 891-894
    Google Scholar
  • 68 Romney M, Sherlock C, Stephens G, Clarke A. Pseudo-outbreak of Pseudomonas putida in a hospital outpatient clinic originating from a contaminated commercial anti-fog solution - Vancouver, British Columbia.  Can Commun Dis Rep. 2000;  26 183-184
    Google Scholar
  • 69 Esteban J, Gadea I, Fernández-Roblas R. et al . Pseudo-outbreak of Aeromonas hydrophila isolates related to endoscopy.  J Hosp Infect. 1999;  41 313-316
    CrossrefGoogle Scholar
  • 70 Centers for Disease Control . Nosocomial Infection and Pseudoinfection from Contaminated Endoscopes and Bronchoscopes - Wisconsin and Missouri.  MMWR Morb Mortal Wkly Rep. 1991;  40 675-678
    Google Scholar
  • 71 Schulze-Röbbecke R, Janning B, Fischeder R. Occurrence of mycobacteria in biofilm samples.  Tubercle and Lung Disease. 1992;  73 141-144
    CrossrefGoogle Scholar
  • 72 American Thoracic Society . Diagnosis and treatment of disease caused by nontuberculous mycobacteria.  Am J Respir Crit Care Med. 1997;  156 1-25
    Google Scholar
  • 73 Agerton T, Valway S, Gore B. et al . Transmission of a highly drug-resistant strain (strain W1) of Mycobacterium tuberculosis. Community outbreak and nosocomial transmission via a contaminated bronchoscope.  JAMA. 1997;  278 1073-1077
    CrossrefGoogle Scholar
  • 74 Bryce E A, Walker M, Bevan C, Smith J A. Contamination of bronchoscopes with Mycobacterium tuberculosis.  Can J Infect Control. 1993;  8 35-36
    Google Scholar
  • 75 Silva C V, Magalhães V D, Pereira C R, Kawagoe J Y, Ikura C, Ganc A J. Pseudo-outbreak of Pseudomonas aeruginosa and Serratia marcescens related to bronchoscopes.  Infect Control Hosp Epidemiol. 2003;  24 195-197
    CrossrefGoogle Scholar
  • 76 Wilson S J, Everts R J, Kirkland K B, Sexton D J. A pseudo-outbreak of Aureobasidium species lower respiratory tract infections caused by reuse of single-use stopcocks during bronchoscopy.  Infect Control Hosp Epidemiol. 2000;  21 470-472
    Google Scholar
  • 77 Dawson D J, Armstrong J G, Blacklock Z M. Mycobacterial cross-contamination of bronchoscopy specimens.  Am Rev Respir Dis. 1982;  126 1095-1097
    Google Scholar
  • 78 Hoy J, Rolston K, Hopfer R L. Pseudoepidemic of Mycobacterium fortuitum in bone marrow cultures.  Am J Infect Control. 1987;  15 26 871
    Google Scholar
  • 79 Verweij P E, Voss A, Donnelly J P, de Pauw B E, Meis J F. Wooden sticks as the source of a pseudoepidemic of infection with Rhizopus microsporus var. rhizopodiformis among immunocompromised patients.  J Clin Microbiol. 1997;  35 2422-2423
    Google Scholar
  • 80 Maniar A C, Vanbuckenhout L R. Mycobacterium kansasii from an environmental source.  Can J Publ Health. 1976;  67 59-63
    Google Scholar
  • 81 Graham L JR, Warren N G, Tzsang A Y, Dalton H P. Mycobacterium avium complex pseudobacteriuria from a hospital water supply.  J Clin Microbiol. 1988;  26 1034-1036
    Google Scholar
  • 82 Schulze-Röbbecke R, Buchholtz K. Heat susceptibility of aquatic mycobacteria.  Appl Environ Microbiol. 1992;  58 1869-1873
    Google Scholar
  • 83 Centers for Disease Control and Prevention . Misdiagnoses of tuberculosis resulting from laboratory cross-contamination of Mycobacterium tuberculosis cultures - New Jersey, 1998.  MMWR Morb Mortal Wkly Rep. 2000;  49 413-416
    Google Scholar
  • 84 Grinbaum R S, Guimarães T, Kusano E, Hosino N, Sader H, Cereda R F. A pseudo-outbreak of vancomycin-resistant Enterococcus faecium.  Infect Control Hosp Epidemiol. 2003;  24 461-464
    CrossrefGoogle Scholar
  • 85 Oda G V, deVries M M. Pseudo-outbreak of Mycobacterium scrofulaceum linked to cross-contamination with a laboratory reference strain.  Infect Control Hosp Epidemiol. 2001;  22 649-651
    CrossrefGoogle Scholar
  • 86 Ho P L, Luk W K, Wong S Y, Seto W H, Lo Y C, Yuen K Y. Pseudobacteremia with amoxycillin-clavulanic acid-resistant Escherichia coli traced to cross-contamination during blood culture processing.  Chin Med J (Engl). 1998;  111 570-576
    Google Scholar
  • 87 Patterson J E, Chapin-Robertson K, Waycott S. et al . Pseudoepidemic of Nocardia asteroides associated with a mycobacterial culture system.  J Clin Microbiol. 1992;  30 1357-1360
    Google Scholar
  • 88 Hopfer R L, Katz R L, Fainstein V. Pseudooutbreak of cryptococcal meningitis.  J Clin Microbiol. 1982;  15 1141-1143
    Google Scholar
  • 89 Singer D A, Jochimsen E M, Gielerak P, Jarvis W R. Pseudo-outbreak of Enterococcus durans infections and colonization associated with introduction of an automated identification system software update.  J Clin Microbiol. 1996;  34 2685-2687
    Google Scholar
  • 90 Tsakris A, Pantazi A, Pournaras S, Maniatis A, Polyzou A, Sofianou D. Pseudo-outbreak of imipenem-resistant Acinetobacter baumannii resulting from false susceptibility testing by a rapid automated system.  J Clin Microbiol. 2000;  38 3505-3507
    Google Scholar
  • 91 Apisarnthanarak A, Kiratisin P, Thongphubeth K, Yuakyen C, Mundy L M. Pseudo-outbreak of Acinetobacter lwoffii infection in a tertiary care center in Thailand.  Infect Control Hosp Epidemiol. 2007;  28 637-639
    CrossrefGoogle Scholar
  • 92 Gust D A, Wang S A, Black C M. et al . A pseudo-outbreak of Chlamydia trachomatis in a state residential facility: implications for diagnostic testing.  J Infect Dis. 2002;  185 841-844
    CrossrefGoogle Scholar
  • 93 Centers for Disease Control and Prevention . Guidelines for the prevention of intravascular catheter-related infections.  MMWR Morb Mortal Wkly Rep. 2002;  51(No. RR-10) 1-29
    Google Scholar
  • 94 Safdar A, Singhal S, Mehta J. Clinical significance of non-Candida fungal blood isolation in patients undergoing high-risk allogeneic hematopoietic stem cell transplantation (1993 - 2001).  Cancer. 2004;  100 2456-2461
    CrossrefGoogle Scholar
  • 95 Weinbaum F I, Lavie S, Danek M, Sixsmith D, Heinrich G F, Mills S S. Doing it right the first time: quality improvement and the contaminant blood culture.  J Clin Microbiol. 1997;  35 563-565
    Google Scholar
  • 96 Medeiros E A, Lott T J, Colombo A L. et al . Evidence for a pseudo-outbreak of Candida guilliermondii fungemia in a university hospital in Brazil.  J Clin Microbiol. 2007;  45 942-947
    Google Scholar
  • 97 Barbut F, Kosmann M J, Lalande V, Neyme D, Coppo P, Gorin N C. Outbreak of Ralstonia pickettii pseudobacteremia among patients with hematological malignancies.  Infect Control Hosp Epidemiol. 2006;  27 642-644
    CrossrefGoogle Scholar
  • 98 Ciftçi E, Güriz H, Aysev A, Kendirli T, Ince E, Atasay B, Doğru U. Alcaligenes xylosoxidans subspecies denitrificans pseudobacteraemia in a university children’s hospital.  J Hosp Infect. 2002;  52 73-74
    CrossrefGoogle Scholar
  • 99 Luk W K. An outbreak of pseudobacteraemia caused by Burkholderia pickettii: the critical role of an epidemiological link.  J Hosp Infect. 1996;  34 59-69
    CrossrefGoogle Scholar
  • 100 Labarca J A, Garcia P, Balcells M E. et al . Pseudo-outbreak of Ochrobactrum anthropi bacteremia related to cross-contamination from erythrocyte sedimentation tubes.  Infect Control Hosp Epidemiol. 2007;  28 763-764
    CrossrefGoogle Scholar
  • 101 Smith J, Ashhurst-Smith C, Norton R. Pseudomonas fluorescens pseudobacteraemia: a cautionary lesson.  J Paediatr Child Health. 2002;  38 63-65
    Google Scholar
  • 102 Rogues A M, Sarlangue J, de Barbeyrac B. et al . Agrobacterium radiobacter as a cause of pseudobacteremia.  Infect Control Hosp Epidemiol. 1999;  20 345-347
    CrossrefGoogle Scholar
  • 103 Finkelstein R, Kassis E, Lapidot-Farkash A. et al . Mechanism of cross-contamination of blood culture bottles in a pseudoepidemic of Enterobacter cloacae bacteremia.  Clin Infect Dis. 1998;  27 1335
    Google Scholar
  • 104 Simhon A, Rahav G, Shapiro M, Block C. Skin disease presenting as an outbreak of pseudobacteremia in a laboratory worker.  J Clin Microbiol. 2001;  39 392-393
    CrossrefGoogle Scholar
  • 105 Kappstein I, Krause G, Hauer T, Jonas D. Pseudo-outbreak of candidaemia with Candida parapsilosis.  J Hosp Infect. 1998;  40 164-165
    CrossrefGoogle Scholar
  • 106 Ashford D A, Kellerman S, Yakrus M. et al . Pseudo-outbreak of septicemia due to rapidly growing mycobacteria associated with extrinsic contamination of culture supplement.  J Clin Microbiol. 1997;  35 2040-2042
    Google Scholar
  • 107 Burwen D R, Margo C E, McNeil M M. et al . A pseudoepidemic of postoperative scleritis due to misdiagnosis.  Infect Control Hosp Epidemiol. 1999;  20 539-542
    CrossrefGoogle Scholar
  • 108 Hernandez C, Meunier O, Audeoud F, Lutz P, Bientz M. Use of pulsed-field gel electrophoresis for a pseudoepidemic of Clostridium difficile infections in a pediatric oncology and hematology department.  Infect Control Hosp Epidemiol. 2004;  25 708-709
    CrossrefGoogle Scholar
  • 109 La Scola B, Fournier P E, Musso D, Tissot-Dupont H. Pseudo-outbreak of listeriosis elucidated by pulsed-field gel electrophoresis.  Eur J Clin Microbiol Infect Dis. 1997;  16 756-760
    CrossrefGoogle Scholar
  • 110 Bales S, Baumann H G, Schnitzler N. Infektionsschutzgesetz - Kommentar und Vorschriftensammlung. Stuttgart, Berlin, Köln; Kohlhammer 2001
    Google Scholar
  • 111 Wendt C, Herwaldt L A. Epidemics: identification and management. In: Wenzel RP (ed) Prevention and Control of Nosocomial Infections, 3. Auflage. Baltimore; Williams & Wilkins 1997: 175-213
    Google Scholar
  • 112 Calfee D P, Brooks J, Zirk N M, Giannetta E T, Scheld W M, Farr B M. A pseudo-outbreak of nosocomial infections associated with the introduction of an antibiotic management programme.  J Hosp Infect. 2003;  55 26-32
    CrossrefGoogle Scholar
  • 113 Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut . Anforderungen an die Hygiene bei der Aufbereitung flexibler Endoskope und endoskopischen Zusatzinstrumentariums.  Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz. 2002;  45 395-411
    Google Scholar
  • 114 Ernst D J. Controlling blood-culture contamination rates.  MLO Med Lab Obs. 2004;  36 14-18
    Google Scholar
  • 115 Schifman R B, Strand C L, Meier F A, Howanitz P J. Blood culture contamination: a College of American Pathologists Q-Probes study involving 640 institutions and 497 134 specimens from adult patients.  Arch Pathol Lab Med. 1998;  122 216-221
    Google Scholar

PD Dr. med. Roland Schulze-Röbbecke

Universitätsklinikum Düsseldorf
Institut für Medizinische Mikrobiologie und Krankenhaushygiene

Universitätsstraße 1
40225 Düsseldorf

Email: schulzrr@uni-duesseldorf.de

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