Outbreak of bacterial endocarditis associated with an oral surgery practice: New Jersey public health surveillance, 2013 to 2014

Background: In October and November 2014, the New Jersey Department of Health received reports of 3 patients who developed Enterococcus faecalis endocarditis after undergoing surgical procedures at the same oral surgery practice in New Jersey. Bacterial endocarditis is an uncommon but life-threateni...

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Bibliographic Details
Main Authors: Frontin, S. (Author), Giles, H. (Author), Greeley, R.D (Author), Kulkarni, P.A (Author), Mehr, J.S (Author), Montana, B.E (Author), Montoya, L.A (Author), Ross, K.M (Author), Weigle, T.J (Author)
Format: Article
Language:English
Published: American Dental Association 2018
Subjects:
Online Access:View Fulltext in Publisher
LEADER 03430nam a2200421Ia 4500
001 10.1016-j.adaj.2017.10.002
008 220706s2018 CNT 000 0 und d
020 |a 00028177 (ISSN) 
245 1 0 |a Outbreak of bacterial endocarditis associated with an oral surgery practice: New Jersey public health surveillance, 2013 to 2014 
260 0 |b American Dental Association  |c 2018 
856 |z View Fulltext in Publisher  |u https://doi.org/10.1016/j.adaj.2017.10.002 
520 3 |a Background: In October and November 2014, the New Jersey Department of Health received reports of 3 patients who developed Enterococcus faecalis endocarditis after undergoing surgical procedures at the same oral surgery practice in New Jersey. Bacterial endocarditis is an uncommon but life-threatening condition; 3 patients with enterococcal endocarditis associated with a single oral surgery practice is unusual. An investigation was initiated because of the potential ongoing public health risk. Methods: Public health officials conducted retrospective surveillance to identify additional patients with endocarditis associated with the practice. They interviewed patients using a standardized questionnaire. An investigative public health team inspected the office environment, interviewed staff, and reviewed medical records. Results: Public health officials identified 15 confirmed patients with enterococcal endocarditis of those patients who underwent procedures from December 2012 through August 2014. Among these patients, 12 (80%) underwent cardiac surgery. One (7%) patient died from complications of endocarditis and subsequent cardiac surgery. Breaches of recommended infection prevention practices were identified that might have resulted in transmission of enterococci during the administration of intravenous sedation, including failure to perform hand hygiene and failure to maintain aseptic technique when performing procedures and handling medications. Conclusions: This investigation highlights the importance of adhering to infection prevention recommendations in dental care settings. No additional patients with endocarditis were identified after infection prevention and control recommendations were implemented. Practical Implications: Infection prevention training should be emphasized at all levels of professional dental training. All dental health care personnel establishing intravenous treatment and administering intravenous medications should be trained in safe injection practices. © 2018 American Dental Association 
650 0 4 |a bacterial endocarditis 
650 0 4 |a Disease Outbreaks 
650 0 4 |a Endocarditis 
650 0 4 |a Endocarditis, Bacterial 
650 0 4 |a Enterococcus faecalis 
650 0 4 |a epidemic 
650 0 4 |a health care–associated outbreak 
650 0 4 |a health survey 
650 0 4 |a human 
650 0 4 |a Humans 
650 0 4 |a infection control 
650 0 4 |a injection safety 
650 0 4 |a New Jersey 
650 0 4 |a Public Health Surveillance 
650 0 4 |a Retrospective Studies 
650 0 4 |a retrospective study 
700 1 |a Frontin, S.  |e author 
700 1 |a Giles, H.  |e author 
700 1 |a Greeley, R.D.  |e author 
700 1 |a Kulkarni, P.A.  |e author 
700 1 |a Mehr, J.S.  |e author 
700 1 |a Montana, B.E.  |e author 
700 1 |a Montoya, L.A.  |e author 
700 1 |a Ross, K.M.  |e author 
700 1 |a Weigle, T.J.  |e author 
773 |t Journal of the American Dental Association