An Episodic Outbreak of Genetically RelatedBurkholdebja cepaciaAmong Non-Cystic Fibrosis Patients at a University Hospital

Abstract

Despite an extensive investigation, the source of the B. cepacia clone involved in this outbreak remains unknown. The spatial and temporal pattern of cases suggests that cross-transmission of a genetically related strain contributed to clustering among patients. The initiation of contact isolation may have limited the extent of this transmission. Additional studies are needed to elucidate better the epidemiology of nosocomial B. cepacia infection among non-CF adult patients.

Nosocomial Burkholderia cepacia infections in a Turkish university hospital: a five-year surveillance

“…In the literature, reports of nosocomial B. cepacia infections are restricted to the epidemics [1][2][3]5,19]. Consistent with the nature of nosocomial epidemics, breaks in infection control as well as the high transmissibily of the microroganism are mostly responsible for the B. Cepacia epidemics.…”

“…B. cepacia is virtually nonpathogenic in healthy hosts. It is commonly associated with colonization and pulmonary infection in CF patients [1,10,11]. However, the pathogenicity of B. cepacia is not always limited to individuals with CF.…”

“…The outbreaks due to B. cepacia have frequently occurred in ICUs, and have been traced to sources related to the respiratory route, nebulised medication, mouthwash and the disinfectant [2,3,5]. Contaminated products, including tap, distilled, or deionized water; contaminated chlorhexidine; topical anesthetic agents; benzalkonium chloride; povidone iodine solution; and quarternary ammonium solutions were responsible for numerous outbreaks in a hospital setting [1,4]. B. cepacia has been associated with outbreaks involving infections of the bloodstream, respiratory tract, and urinary tract [4].…”

“…It is widely distributed in the natural environment and has been isolated from water, soil, fruits, and vegetables. B. cepacia has emerged as an serious human pathogen in the last two decades, causing fatal necrotizing pneumonia and bacteremia, especially in patients with cystic fibrosis (CF) or chronic granulomatous disease [1][2][3][4]. B. cepacia was isolated in 0.2-0.6% of all ventilator-associated pneumonias reported to the National Nosocomial Infections Surveillance System (NNIS) in the United States between 1998 and 2004 [2,5].…”

Multistate Outbreak of an Emerging Burkholderia cepacia Complex Strain Associated With Contaminated Oral Liquid Docusate Sodium

“…We personally spoke with the families of the affected patients and provided all families in the PICU with an informational handout, which was well received. Lastly, while some B. cepacia outbreaks have never been linked to a known source, 7 B. cepacia has relatively low occurrence in non-cystic fibrosis patients. Therefore, identification of a cluster of infections, particularly those caused by an identical strain, should raise suspicion for possible product contamination or infection control deficiencies, and should prompt further investigation.…”