|
Nasal infection of two comatose
patients with fly larvae has been linked to a Missouri hospital's widespread
mouse infestation, which occurred after the hospital laid off housekeeping
staff.
The disruption or loss of one
vital link in hospital organization (in this case, housekeeping support)
may lead to an unintended and bizarre outcome.
In the first instance, maggots
were found in the mouth and nose of
a 45-year-old man 10 days after he was admitted to the hospital's intensive
care unit (ICU) in July 1998. The patient died from an unrelated
cause 2 days after the larvae were removed.
Two months later, maggots
were found around the nasotracheal tube of a 49-year-old man
8 days after he was admitted to the ICU of the same hospital. The larvae,
along with adult flies found in the area, were retrieved and later identified
as P. sericata, or green blowflies. More than 100 green blowfly eggs can
grow and mature to adulthood in a typical mouse carcass, the report indicates.
Hospital personnel had previously
complained about fly infestation of the ICU, but the problem was thought
to be due to construction that required the constant opening of windows
and doors. The installation of insect light traps in the medical ICU and
adjacent corridors did little to abate the problem.
Upon
inspection of the hospital cafeteria and canteen, mouse carcasses were
found in food storage rooms, mouse nests were found on food shelves, live
mice were found trapped in a wastebasket and numerous mouse droppings
were observed on the canteen workroom floor.
Neither the cafeteria nor the
canteen had been cleaned for at least one year due to downsizing of housekeeping
personnel, the researchers note.
According to other media sources,
the incident occurred at the Kansas City Veteran's Administration Medical
Center.
Archives
of Internal Medicine March 25, 2002;162:638-640
| 