Bed Bug Infestation on a Maternity Unit in a Teritary Care Center

Background: Bedbug infestation occurs worldwide and is in increasingly common in the United States, Canada, and the United Kingdom. Bed bug (Cimex lectularius) is a wingless, red-brown, blood-sucking insect about 7mm in length with a lifespan ranging from four months to a year. Bed bugs are nocturnal insects that hide in cracks and crevices in beds, wooden furniture, floors and walls.  Bed bug infestation has been reported in hotels, college dormitories, airports, homes, shelters, and hospitals.

Objective: To describe the experience of a large tertiary care center during a bed bug infestation outbreak on a maternity unit between September and October 2009.

Methods: On September 30, 2009, a single visual observation of bed bugs on the sleeper chair in the room of a post partum patient on unit A was reported. Extermination protocols were immediately implemented. Upon the identification of two additional infested rooms on October 2^nd, the extermination company expanded their assessment of the unit by using a canine specialist (trained beagle) to inspect all rooms on unit A. Positive canine identification of bed bug infestation occurred in eleven additional rooms.  There had been no reports of bites to patients or family members. However, during the week of October 5^th, two family members, who slept on recliners, were diagnosed with bed bug bites.  A multidisciplinary team was convened to plan and organize strategies, which consisted of staff and patient education, discarding recliners in all patient rooms on unit A, scheduled extermination of affected rooms using the cryonite method, development of bed bug guidelines, and expansion of active canine inspection to two additional maternity units, the neonatal intensive care unit and common areas.

Results: An additional two rooms on unit B, three rooms on unit C (labor & delivery), and several offices belonging to obstetric and the medicine department were identified with infestation, and received cryonite extermination. Policy and procedures were expanded to include quarterly inspection of high risk sleeping areas, along with service recovery strategies for inpatients, families and visitors.

Conclusions: It is essential for healthcare institutions to recognize the risk of bed bug infestation and the need for protocols to prevent, identify and eliminate infestation. Successful eradication can occur by swift action, collaboration, and planning with a qualified extermination specialist via a  multidisciplinary team.