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Epidemiology

Nosocomial Pseudoepidemic Caused by Bacillus cereus Traced to Contaminated Ethyl Alcohol from a Liquor Factory

Po-Ren Hsueh, Lee-Jene Teng, Pan-Chyr Yang, Hui-Lu Pan, Shen-Wu Ho, Kwen-Tay Luh
Po-Ren Hsueh
Departments of Laboratory Medicine and
Internal Medicine, National Taiwan University Hospital, and
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Lee-Jene Teng
Departments of Laboratory Medicine and
School of Medical Technology,National Taiwan University College of Medicine, Taipei, Taiwan
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Pan-Chyr Yang
Internal Medicine, National Taiwan University Hospital, and
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Hui-Lu Pan
Departments of Laboratory Medicine and
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Shen-Wu Ho
Departments of Laboratory Medicine and
School of Medical Technology,National Taiwan University College of Medicine, Taipei, Taiwan
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Kwen-Tay Luh
Departments of Laboratory Medicine and
Internal Medicine, National Taiwan University Hospital, and
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DOI: 10.1128/JCM.37.7.2280-2284.1999
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    Fig. 1.

    RAPD patterns of the 19 isolates of Bacillusspecies generated by APPCR with the primers OPA-1 (A) and ERIC1 (B). Lanes: M, molecular size marker; 1 to 13, B. cereus isolates P2 to P5, P8, P9, P12 to P15, S1, N1, and L1, respectively; 14 to 16,B. sphaericus isolates P1, L11, and L12, respectively; 17 to 19, isolates U1 to U3; 20 to 28, nine additional epidemiologically unrelated B. cereus isolates (see Table 1).

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  • Table 1.

    Phenotypic and genotypic characteristics of 50 isolates of Bacillus species

    Isolate (location)aSpeciesDate of isolation (day/mo/yr)SourceAntibiotype as determined by:Biotype as determined by Vitek BacilluscardRAPD pattern as determined with OPA-1 or ERIC1 primerClone (B. cereus)
    Disk diffusionE test
    Isolates from patients
     P1 (OW)B. sphaericus1/5/1990Blood2IIICf
     P2 (OW)B. cereus20/9/1990Pleural effusion1IAaA
     P3 (SICU)B. cereus10/9/1990Blood1IIBbB
     P4 (ED)B. cereus19/9/1990Blood1IIBbB
     P5 (ED)B. cereus5/10/1990Blood1IAaA
     P6 (OW)B. cereus20/9/1990Blood1IIBbB
     P7 (PW)B. cereus20/9/1990Blood1IIBbB
     P8 (ED)B. cereus20/9/1990Blood1IIBbB
     P9 (ED)B. cereus20/9/1990Blood1IIBbB
     P10 (ED)B. cereus20/9/1990Blood1IIBbB
     P11 (ED)B. cereus20/9/1990Blood1IIBbB
     P12 (ED)B. cereus4/10/1990Blood1IIBbB
     P13 (OW)B. cereus4/10/1990Blood1IIBbB
     P14 (ED)B. cereus5/10/1990Blood1IIBbB
     P15 (ED)B. cereus5/10/1990Blood1IIBbB
     P16 (ED)B. cereus5/10/1990Blood1IIBbB
    Isolates from alcohol used in hospital
     S1–S9 (ED)B. cereus8/10/199070% alcohol1IIBbB
     S10–S14 (OW)B. cereus8/10/199070% alcohol1IIBbB
     N1–N5 (PD)B. cereus12/10/199095% alcohol1IIBbB
    Isolates from factory
     L1–L10B. cereus23/10/199095% alcohol1IIBbB
     L11–12B. sphaericus23/10/199095% alcohol2IVCg
    Epidemiologically unrelated isolates
     U-1B. cereus9/3/1998Blood1VBcC
     U-2B. cereus13/8/1998Blood1VIAdD
     U-3B. cereus15/8/1998Blood1VIIBeE
    • ↵a OW, oncology ward; SICU, surgical intensive care unit; ED, emergency department; PW, pediatric ward; PD, pharmacy department.

  • Table 2.

    Susceptibilities to 16 antimicrobial agents of 50 isolates of Bacillus species identified by antibiotype

    Antimicrobial agentMIC (μg/ml) forBacillus sp. E-test antibiotype:Result forBacillus sp. disk antibiotypea:
    IIIIIIIVVVIVII1  2
    Penicillin16641644≥2564RR
    Ampicillin≥256≥256828≥25664RS
    Ampicillin-sulbactam432414324
    Cefazolin64≥2568264≥256128RS
    Cefotaxime128≥25640.532≥25632
    Cefepime≥2566440.25≥256≥256≥256
    Imipenem0.250.060.50.06124
    Chloramphenicol1.00.50.50.540.250.25SS
    Erythromycin0.030.030.030.060.250.120.5SS
    Gentamicin1211221SS
    Trimethoprim-sulfamethoxazole≥32≥32≥32≥32≥32≥32≥32
    Vancomycin2221444SS
    Teicoplanin4221222
    Ciprofloxacin1.01.01.00.5484
    MinocyclineSS
    TetracyclineSS
    • ↵a R, resistant; S, susceptible.

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Nosocomial Pseudoepidemic Caused by Bacillus cereus Traced to Contaminated Ethyl Alcohol from a Liquor Factory
Po-Ren Hsueh, Lee-Jene Teng, Pan-Chyr Yang, Hui-Lu Pan, Shen-Wu Ho, Kwen-Tay Luh
Journal of Clinical Microbiology Jul 1999, 37 (7) 2280-2284; DOI: 10.1128/JCM.37.7.2280-2284.1999

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Nosocomial Pseudoepidemic Caused by Bacillus cereus Traced to Contaminated Ethyl Alcohol from a Liquor Factory
Po-Ren Hsueh, Lee-Jene Teng, Pan-Chyr Yang, Hui-Lu Pan, Shen-Wu Ho, Kwen-Tay Luh
Journal of Clinical Microbiology Jul 1999, 37 (7) 2280-2284; DOI: 10.1128/JCM.37.7.2280-2284.1999
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KEYWORDS

Bacillaceae Infections
Bacillus cereus
Cross Infection
Disinfectants
Drug Contamination
ethanol

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