Shands bacterial infections occurred between March and July 22


Published: Tuesday, July 30, 2013 at 3:10 p.m.
Last Modified: Tuesday, July 30, 2013 at 3:10 p.m.

Seven patients in the burn unit of the UF Health Shands Hospital were infected with a lethal, drug-resistant bacteria between sometime in March and July 22, the hospital's chief medical officer said at a news briefing Tuesday.

Dr. Timothy Flynn, the hospital's chief medical officer and the senior associate dean for medical affairs, said the most recently infected patient last week has tested negative for the bacteria, called acinetobacter baumannii.

"There are no cases in other areas of the hospital. No one in the hospital is currently infected," Flynn said.

Flynn was asked if any of the seven patients had died. He declined comment, saying he did not want to discuss individual patients.

Keith Mahabirsingh, a truck driver from Ocala who suffered burns over 50 percent of his body when his truck crashed and burst into flames, died at the Shands burn unit on July 10.

His family said Mahabirsingh developed lung and blood infections shortly before he died. His mother said on Tuesday that she suspected those infections might have been related to the acinetobacter baumannii bacteria.

Acinetobacter baumannii typically causes serious infections in the lungs, blood and brain.

Mahabirsingh's wife said her husband seemed to be doing fine for the first 17 days after he was admitted to the hospital on June 20.

"He was trying so hard. His body was just working up a storm to heal," Lydia Mahabirsingh said.

But then he contracted an infection in his lungs; then his blood.

He was treated with antibiotics, but they didn't work and his organs began to rapidly shut down, she said.

"When he passed away, he was practically skinless" and vulnerable to infections, Lydia Mahabirsingh said, adding she doesn't know what kind of infections he had and what caused them.

"I certainly don't want to blame anyone," she said.

Her husband's death certificate cites "complications of thermal injuries sustained in a motor vehicle accident" as the cause of death, but Lydia Mahabirsingh is awaiting an autopsy report.

Paul Myers, administrator of the Alachua County Health Department, said deaths caused by acinetobacter baumannii-related infections are not reportable to the health department (unlike communicable diseases like measles), so they are not tracked.

"Many of the patients who have bacterial infections have a lot of other underlying conditions, so that's going to complicate death certificates," Myers said.

When asked about the cause of Mahabirsingh's death, Melissa Lutz Blouin, a UF spokeswoman, said the hospital could not release information on individual patients.

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In early March, the first patient at Shands tested positive for the bacteria, and starting in late May six other patients tested positive for it.

"Once it was clear that this was not an isolated case, steps were taken to move (uninfected or newly admitted) patients off the (burn) unit" to prevent further spread of infection, Blouin said.

The infected patients continued to be treated in the burn unit, she said.

Members of the hospital staff were aware of the bacteria, but the hospital did not inform the health department of the outbreak, Blouin said.

Flynn estimates that 20 to 25 patients in the burn unit have been relocated within the hospital over the past five months since the outbreak occurred.

Because acinetobacter baumannii lives on surfaces (and in soil), the hospital closed the burn unit to revamp it and conducted surveillance cultures throughout the hospital to prevent further spread of the bacteria, Flynn said.

Molecular testing of the bacteria from infected patients indicates there was a single source of bacteria that spread from patient to patient.

The bacteria can spread from human contact and through medical devices, such as urine catheters and blood pressure cuffs.

The hospital has not yet determined how and when exactly the bacteria were introduced to the hospital. Flynn said the hospital is using the incident as an opportunity to revisit its cleaning and infection-control measures.

This is not the first occurrence of acinetobacter baumannii at Shands Hospital. Flynn said "there's been at least one in the past five years," and that in the past, most have been sporadic, isolated cases of the bacteria.

"We are shocked and sorrowful about this (situation)," Flynn said.

He said that some of the patients were successfully treated and that outcomes depended on the health and degree of burns the patients had before infection.

The only antibiotic known to treat acinetobacter baumannii, called Colistin, can be toxic to the kidneys, so the hospital tried to avoid using it, Flynn added.

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