An outbreak investigation of Burkholderia cepacia infections related with contaminated chlorhexidine mouthwash solution in a tertiary care center in Turkey

Bilgin, Hüseyin; Gelmez, Gülşen Altınkanat; Bayrakdar, Fatma; Sayın, Elvan; Gül, Fethi; Pazar, Nazlı; Culha, Gulcan; Yıldız, Sulhiye; Cinel, İsmail; Korten, Volkan

doi:10.1186/s13756-021-01004-8

Cited by 10 publications

(7 citation statements)

References 22 publications

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“…It turned out to be a batch of MWS with chlorhexidine that had been used in the clinical management of the patients. Five of the six patients died despite the antibiotic therapies provided, although the retrospective analysis ruled out that the cause of death of one of the patients was Bcc infection [ 16 ].…”

Section: Outbreaks Of Nosocomial Infections By Bccmentioning

confidence: 99%

“…Furthermore, the combination of available diagnostic and epidemiological tools is essential to distinguish Bcc infections in a timely manner, allowing an appropriate clinical approach to affected individuals. However, the constant search for and notification of cases of nosocomial infections due to Bcc are not mandatory practices in different cities and nations [ 6 , 16 ], which contributes to the constant risk for people with certain predisposing characteristics, such as those suffering from chronic obstructive pulmonary disease (COPD), ventilator‑associated pneumonia (VAP) [ 18 ], or CF [ 1 , 5 , 19 ].…”

Section: Outbreaks Of Nosocomial Infections By Bccmentioning

confidence: 99%

“…Antibiotic therapy is essential in the clinical management of CF patients infected by Bcc [ 20 ] since timely eradication can prevent the rapid decline of lung function and improve quality of life [ 41 ]. Studies in the Cochrane database of systematic reviews have recognized that therapy for Bcc lung infections in people with CF is a significant challenge [ 42 , 58 , 59 ], due to factors as diverse as the natural multi-antimicrobial resistance of Bcc species [ 1 , 2 , 40 ], their intrinsic resistance to disinfectants and antiseptics [ 16 ], their strong ability to develop resistance to other antimicrobial agents [ 1 , 3 , 20 ], including those of last option [ 60 ], the high variability in the expression of virulence factors in each strain [ 45 ], their ability to survive intracellularly in lung epithelial cells and macrophages [ 21 , 45 ], and the establishment of biofilms [ 7 ]. Thus, the choice of the appropriate antibiotics is complicated due to the innate resistance of Bcc to carboxypenicillins, first-second-generation cephalosporins, polymyxins [ 7 ] and according to EUCAST Guidance Document on Burkholderia cepacia complex, to all aminoglycosides ( https://www.eucast.org/eucastguidancedocuments ).…”

Section: Suggested Antimicrobials For the Eradication Of Bc...mentioning

confidence: 99%

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Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy

Gutiérrez Santana,

Coria Jiménez

2024

Annals of Medicine

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Burkholderia cepacia complex ( Bcc ) is a bacterial group with ‘natural’ multi-antimicrobial resistance. This complex has generated epidemic outbreaks across the world. In people with cystic fibrosis (CF), Bcc can cause severe lung infections that lead to accelerated lung damage, which can be complicated by necrotizing pneumonia accompanied by high fevers, leucocytosis, and bacteraemia, which commonly causes fatal outcomes. Specifically, infection by Burkholderia cenocepacia is considered an exclusion criterion for lung transplantation. The species of Bcc exhibit both genetic and phenotypic hypervariability that complicate their accurate microbiological identification. Automated methods such as MALDI-TOF can err in the determination of species. Their slow growth even in selective agars and the absence of international consensuses on the optimal conditions for their isolation make early diagnosis a difficult challenge to overcome. The absence of correlations between antibiograms and clinical results has resulted in the absence of standardized cut-off values of antimicrobial susceptibility, a fact that brings a latent risk since incorrect antibiotic therapy can induce the selection of more aggressive variants that worsen the clinical picture of the host, added to the absence of a clear therapeutic guide for the eradication of pulmonary infections by Bcc in patients with CF, resulting in frequently ineffective treatments. There is an urgent need to standardize methods and diagnostic tools that would allow an early and accurate diagnosis, as well as to perform clinical studies of the effectiveness of available antibiotics to eradicate Bcc infections, which would allow us to establish standardized therapeutic schemes for Bcc -infected patients.

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Section: Outbreaks Of Nosocomial Infections By Bccmentioning

confidence: 99%

Section: Outbreaks Of Nosocomial Infections By Bccmentioning

confidence: 99%

Section: Suggested Antimicrobials For the Eradication Of Bc...mentioning

confidence: 99%

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Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy

Gutiérrez Santana,

Coria Jiménez

2024

Annals of Medicine

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“…[6] The oragnism's natural tendency to colonise various surfaces, intra-venous sets, centrallines, nebulizers, respiratory devices and disinfectants makes it a major cause for small hospital outbreaks. [7] Here, we present a series of five cases where an unusual violet pigment producing BCC was identified. To the best of our knowledge this is the first case of violet pigment producing BCC from Mumbai.…”

Section: Introductionmentioning

confidence: 99%

Unusual Violet Coloured Pigment Produced by Burkholderia cepacia Complex – A Report of Five Cases from a Tertiary Care Hospital in Mumbai

De¹,

Shastri²,

Malak³

et al. 2022

JMSH

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Burkholderia cepacia complex (BCC) represent a group of opportunistic organisms that cause a wide variety of infections including the nosocomial. The organism is found to cause sepsis and is also reported to cause blood stream infections in malignancy. Here, we present a case series of five patients with sepsis in which an unsual violet pigment producing BCC was isolated. Keywords: Violet pigment, Burkholderia, Sepsis, Malignancy

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“…1 It has been indicated in chronic nosocomial infections such as septicemia, respiratory tract infections, genitourinary system infections, intracranial infections, endocarditis, gastrointestinal system infections, and surgical site infections. 2 It is classified as an important emerging opportunistic pathogen, especially in immunocompromised hosts. Studies have shown that these bacteria maintain their vitality by attaching to any surface and forming biofilms rather than remaining in their planktonic 3 In addition to having an important role in bacterial adherence and resistance to antibiotics and phagocytosis, biofilms allow bacteria to gain the ability to adapt to the environment by forming a community with new genetic modulations.…”

Section: Introductionmentioning

confidence: 99%

Coating indwelling urinary catheters with moxifloxacin prevents biofilm formation by Burkholderia cepacia

Ghafil¹,

İbrahim²,

Zgair³

2022

Polim. Med.

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Background. Burkholderia cepacia adhesion and biofilm formation onto abiotic surfaces is an important feature of clinically relevant isolates. The in vitro biofilm formation of B. cepacia onto coated indwelling urinary catheters (IDCs) with moxifloxacin has not been previously investigated.Objectives. To examine the ability of B. cepacia to form biofilms on IDCs and the effect of coating IDCs with moxifloxacin on biofilm formation by B. cepacia in vitro. Materials and methods.The adhesion of B. cepacia to coated and uncoated IDCs with moxifloxacin was evaluated. Pieces of IDCs were coated with moxifloxacin (adsorption method). The spectrophotometric method was used to check moxifloxacin leaching into tubes. Coated and uncoated tubes were incubated with 10 7 colony forming units (cfu)/mL of B. cepacia. The viable bacterial count was used to count the number of bacteria adhered to coated and uncoated IDC pieces. Results. A significant adhesion of B. cepacia to uncoated IDC pieces started 15 min after the incubation in a bacterial suspension (10 7 cfu/mL). A maximum adhesion was observed at 48 h. The pretreatment of IDCs with 100 μg/mL of moxifloxacin produced the best adsorption of antibiotic onto the IDCs. Coating IDC pieces with moxifloxacin significantly reduced the adhesion and biofilm formation of B. cepacia (p < 0.05) at various time intervals (1 h, 4 h and 24 h). Conclusions.The present study has demonstrated for the first time that coated IDCs with moxifloxacin reduce B. cepacia adhesion and biofilm formation. This finding has opened the door to the production of the new generation IDCs that prevent bacteria from attaching and forming biofilms.

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An outbreak investigation of Burkholderia cepacia infections related with contaminated chlorhexidine mouthwash solution in a tertiary care center in Turkey

Cited by 10 publications

References 22 publications

Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy

Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy

Unusual Violet Coloured Pigment Produced by Burkholderia cepacia Complex – A Report of Five Cases from a Tertiary Care Hospital in Mumbai

Coating indwelling urinary catheters with moxifloxacin prevents biofilm formation by Burkholderia cepacia

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