Bacillus species pseudo-outbreak: construction works and collateral damage

Published:October 24, 2016DOI:


      We describe the investigation and management of a pseudo-outbreak of Bacillus spp. bacteraemia associated with construction work in an emergency department (ED). During the pseudo-outbreak period 59 out of 3469 (1.7%) blood cultures yielded Bacillus spp. versus 24 out of 7628 (0.31%) in 2012. Material, surfaces, and air samples showed environmental contamination. Cases rapidly declined following the implementation of infection control measures and the end of construction. Construction works at the ED caused environmental contamination that most probably led to the pseudo-outbreak of Bacillus bacteraemia. In hospital settings, the lack of correctly implemented effective barriers during construction may place patients and healthcare providers at risk as well as lead to pseudo-outbreaks.


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        • Fekete T.
        Other than Bacillus anthracis.
        7th ed. Elsevier, Amsterdam2009
        • Setlow P.
        Spores of Bacillus subtilis: their resistance to and killing by radiation, heat and chemicals.
        J Appl Microbiol. 2006; 101: 514-525
        • Kalpoe J.S.
        • Hogenbirk K.
        • van Maarseveen N.M.
        • et al.
        Dissemination of Bacillus cereus in a paediatric intensive care unit traced to insufficient disinfection of reusable ventilator air-flow sensors.
        J Hosp Infect. 2008; 68: 341-347
        • Dolan S.A.
        • Littlehorn C.
        • Glodé M.P.
        • et al.
        Infection with contaminated alcohol prep pads.
        Infect Control Hosp Epidemiol. 2012; 33: 666-671
        • Maki D.G.
        Through a glass darkly. Nosocomial pseudoepidemics and pseudobacteremias.
        Arch Intern Med. 1980; 140: 26-28
        • Hosein I.K.
        • Hoffman P.N.
        • Ellam S.
        • et al.
        Summertime Bacillus cereus colonization of hospital newborns traced to contaminated, laundered linen.
        J Hosp Infect. 2013; 85: 149-154
        • Meites E.
        • Taur Y.
        • Marino L.
        • et al.
        Investigation of increased rates of isolation of Bacillus species.
        Infect Control Hosp Epidemiol. 2010; 31: 1257-1263
        • Hsueh P.R.
        • Teng L.J.
        • Yang P.C.
        • Pan H.L.
        • Ho S.W.
        • Luh K.T.
        Nosocomial pseudoepidemic caused by Bacillus cereus traced to contaminated ethyl alcohol from a liquor factory.
        J Clin Microbiol. 1999; 37: 2280-2284
        • Loeb M.
        • Wilcox L.
        • Thornley D.
        • Gun-Munro J.
        • Richardson H.
        Bacillus species pseudobacteremia following hospital construction.
        Can J Infect Control. 1995; 10: 37-40
      1. Centers for Disease Control and Prevention. Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Available at: [last accessed March 2016].