Septic Arthritis Outbreak Linked to Infection Prevention Violations

An investigation into an outbreak of septic arthritis at an outpatient facility in New Jersey identified multiple breaches of recommended infection prevention practices.

The results of the investigation were published in Infection Control & Hospital Epidemiology (ICHE), the journal for the Society for Healthcare Epidemiology of America (SHEA).

As the ICHE article — "Bacterial septic arthritis infections associated with intra-articular injection practices for osteoarthritis knee pain—New Jersey, 2017" — notes, the N.J. Department of Health received reports of multiple patients who developed septic arthritis following intra-articular injections for osteoarthritis knee pain provided at the same private outpatient facility.

An infection prevention assessment of the facility's practices found 41 patients with septic arthritis associated with intra-articular injections and identified "multiple breaches of recommended infection prevention practices, including inadequate hand hygiene, unsafe injection practices and poor cleaning and disinfection practices."

A SHEA news release notes that of the 41 patients identified, 33 required surgical removal of damaged tissue.

The outbreak was costly, with the release noting that for just 31 affected Medicare patients, charges claimed for treatment surpassed $5 million.

The outpatient facility, which voluntarily stopped performing procedures following the initial septic arthritis reports as well as complaints, was advised by state officials to follow recommendations in the Centers for Disease Control and Prevention’s 2016 Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. It was also recommended that the facility work with an infection prevention consultant on improvements. No additional cases were identified after infection prevention recommendations were implemented.

Study: Healthcare-Acquired Infections Account for 16% of Medical Errors

The results of a new study indicate that healthcare-acquired infections (HAIs) are associated with nearly one in six incidents of preventable patient harm.

The research, published in The BMJ, examined 70 previously published studies covering more than 337,000 patients. Researchers concluded that about one in 10 patients are harmed when receiving care, and around one in 20 patients experience preventable harm. The proportion of severe preventable patient harm causing permanent disability or death was 12%. 

The researchers found that drug management incidents (25%) and other therapeutic management incidents (24%) accounted for the highest proportion of preventable patient harm. They were followed by incidents related to surgical procedures (23%), healthcare infections (16%) and diagnosis (16%).

The study was international, but Maria Panagioti, lead author and a senior lecturer at the University of Manchester, told NBC News that its findings would be applicable to the United States.

The researchers conclude, "Although a focus on preventable patient harm has been encouraged by the international patient safety policy agenda, there are limited quality improvement practices specifically targeting incidents of preventable patient harm rather than overall patient harm. Developing and implementing evidence-based mitigation strategies specifically targeting preventable patient harm could lead to major service quality improvements in medical care which could also be more cost effective."

Ebola Outbreak in Congo Declared Global Emergency By WHO

The World Health Organization (WHO) has declared the Ebola outbreak in the Democratic Republic of Congo (DRC) as a "public health emergency of international concern."

As a WHO news release notes, the declaration follows recent alarming developments concerning the outbreak, including the first confirmed case in Goma, the capital of North Kivu province located in the eastern DRC. About two million people reside in Goma, which is on the border with Rwanda and is described by WHO as "the gateway to the rest of DRC and the world."

WHO released a statement that included a series of recommendations for affected countries, neighboring countries and all countries.

Despite the declaration, WHO acknowledged that the risk of Ebola spreading beyond the affected area is presently low. During a press conference, WHO Director-General Dr. Tedros Adhanom Ghebreyesus is quoted as stating, "Our risk assessment remains that the risk of Ebola spread in DRC and the region remains very high, and the risk of spread outside the region remains low."

The latest Ebola outbreak in DRC was declared in August 2018. As of July 15, 2019, WHO reports the total number of confirmed Ebola cases in the DRC at more than 2,400 and nearly 1,600 confirmed deaths.