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In a follow-up on the Pseudomonas aeruginosa outbreak in hospitals in Norway, the Norwegian Institute of Public Health (NIPH) reports the bacterium was detected in one package with pre-moistened disposable washcloths that are often used for intensive care patients in hospitals.

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Oslo University Hospital (OUS) reported the P. aeruginosa outbreak strain has been detected in one pre-moistened disposable washcloth from an unopened package of the washcloth product “Oasis Bedbath, Unperfumed” from the manufacturer Vernacare in England.

In addition, Pseudomonas aeruginosa has been detected in another eight cloths in the same batch, and these eight will now be genotyped to investigate whether they are identical to the outbreak strain. The findings strengthen the suspicion that the cloths may be a source of infection. Further examinations are carried out and it is mapped out whether the cloths have been used in the health and care service outside hospitals. The disposable wipes are a non-sterile cosmetic product.

The health trusts have participated in an extensive outbreak investigation where, among other things, mapping of infected patients and examination of products and equipment they have been in contact with, has been a priority. Now it will be important to find the extent of contamination in the suspected product, says chief physician Kirsten Gravningen at the National Institute of Public Health.

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The outbreak with the bacterium Pseudomonas aeruginosa in 33 hospitals in Norway now includes 239 patients.

Following the discovery of the outbreak bacterium in the washcloths, Oslo University Hospital (OUS) has contacted Hospital Purchasing, which is the purchasing service for the specialist health service. Hospital procurement has notified all health trusts in Norway to stop using the washcloths from the relevant manufacturer for the time being. They have also notified the Norwegian distributor of the discovery, and the Norwegian Food Safety Authority is following up as the supervisory authority for cosmetic products. NIPH has asked the health trusts to store the products for possible further examination.

During the outbreak investigation, we have worked along several lines at the same time. Regular testing of various patient groups and mapping and examination of products in hospitals have been done. We therefore have a good overview of the extent of the outbreak, and few of those who have been infected have become seriously ill, Gravningen concludes.

The Norwegian Institute of Public Health (NIPH) has coordinated an outbreak group with professionals from all health regions who have worked systematically to limit the outbreak and find the source of the infection. The first case we know of was discovered in October 2021 in Helse Nord, which discovered and led the outbreak in the initial phase, before it became known that there were also cases in other health regions. Since the outbreak bacterium was identified in many hospitals, the suspicion went in the direction of a common external source – a contaminated product or medical equipment that was in use by many patients.

New cases are still being reported, so it may be that more than 239 have been infected.

P. aeruginosa is a common bacterium that thrives in water and humid environments, as well as in a hospital environment. It rarely causes disease in healthy people, but can cause serious infection in intensive care patients and patients with weakened immune systems. Infected patients who get an infection can be treated with antibiotics.