EOC 64 - An Interdisciplinary Approach to Combatting Aeromonas Bloodstream Infections in Dialysis Wall Boxes

Background: Aeromonas hydrophila is a gram-negative bacterium that is found in water and can cause infections in hospitalized patients. Since May 2020, 13 Aeromonas Bloodstream Infections (BSI) were identified by infection prevention in patients undergoing Continuous Renal Replacement Therapy (CRRT) in a surgical Intensive Care Unit (ICU). A multidisciplinary team was formed to develop strategies and solutions for appropriate dialysis wall box use and maintenance.

Methods: Following our investigation and through interdisciplinary collaboration with facilities management, nursing, and infection prevention, we implemented a comprehensive protocol to prevent further transmission of Aeromonas. The process included educating nursing staff on the principles of aseptic technique, new hand hygiene signage posted above dialysis wall boxes in patient rooms, terminal cleaning of wall boxes, installation of brackets to appropriately secure effluent lines, and inserting effluent lines 12-inches down wall box drains to prevent backflow.

Results: Following wall box redesign and preventive maintenance of drain cleaning in all patient rooms, not a single Aeromonas BSI has been identified since June 2023. The interdisciplinary mitigation plans are sustainable efforts in preventive maintenance of biofilm formation and Aeromonas.

Conclusions: We highlight an interdisciplinary response in management of dialysis wall boxes in controlling Aeromonas bloodstream infections in a surgical ICU with critically ill liver transplant patients undergoing CRRT. Ongoing awareness and education with all healthcare personnel was an impactful measure in reducing not only Aeromonas BSIs but also reducing the occurrence of waterborne pathogen formation within dialysis wall boxes.