ISSN: 1449-1907International Journal of Medical Sciences
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Int J Med Sci 2023; 20(5):566-571. doi:10.7150/ijms.82054 This issue Cite
Research Paper
Peripheral Parenteral Nutrition Solutions and Bed Bath Towels as Risk Factors for Nosocomial Peripheral Venous Catheter-related Bloodstream Infection by Bacillus cereus
1. Clinical Pharmacology, Graduate School of Medicine, Yamaguchi University, Japan.
2. Pharmacy Department, Yamaguchi University Hospital, Japan
3. Department of Pharmacy, Hofu Institute of Gastroenterology, Japan
4. Clinical Laboratory, Yamaguchi University Hospital, Japan
5. Department of Infection Prevention and Control, Tokyo Medical University Hospital, Japan
6. Faculty of Pharmaceutical Sciences, Sanyo-Onoda City University, Japan
Abstract
In Japan, China, and Singapore, several studies have reported increased incidences of peripheral venous catheter-related bloodstream infection by Bacillus cereus during the summer. Therefore, we hypothesized that bed bathing with a B. cereus-contaminated “clean” towels increases B. cereus contact with the catheter and increases the odds of contaminating the peripheral parenteral nutrition (PPN). We found that 1) professionally laundered “clean” towels used in hospitals have B. cereus (3.3×104 colony forming units (CFUs) / 25cm2), 2) B. cereus is transferable onto the forearms of volunteers by wiping with the towels (n=9), and 3) B. cereus remain detectable (80∼660 CFUs /50cm2) on the forearms of volunteers even with subsequent efforts of disinfection using alcohol wipes. We further confirmed that B. cereus grow robustly (102 CFUs /mL to more than 106 CFUs /mL) within 24hours at 30°C in PPN. Altogether we find that bed bathing with a towel contaminated with B. cereus leads to spore attachments to the skin, and that B. cereus can proliferate at an accelerated rate at 30°C compared to 20°C in PPN. We therefore highly recommend ensuring the use of sterile bed bath towels prior to PPN administration with catheter in patients requiring bed bathing.
Keywords: venous catheter -related bloodstream infection, Bacillus cereus, peripheral parenteral nutrition, microbial growth
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