An Outbreak of Burkholderia cepacia Bacteremia in a Neonatal Intensive Care Unit

Paul, Liz Mary; Hegde, Ashwini; Pai, Tanvi; Shetty, Sourab; Baliga, Shrikala; Shenoy, Suchitra

doi:10.1007/s12098-015-1855-7

Cited by 24 publications

(18 citation statements)

References 23 publications

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“…First, it enabled accurate identification of BCC to species level and preliminary typing of bacterial strains through MLST. Phenotypic tests and MALDI-TOF mass spectrometry are inaccurate in speciation within BCC, and unlike previous BCC outbreaks, in which identical antibiogram profiles were found among outbreak-related BCC ( 4 , 39 ), the antibiogram profiles among isolates from our patients were variable.…”

Section: Discussioncontrasting

confidence: 63%

Polyclonal Burkholderia cepacia Complex Outbreak in Peritoneal Dialysis Patients Caused by Contaminated Aqueous Chlorhexidine

Wong¹,

Wong²,

Chen³

et al. 2020

Emerg. Infect. Dis.

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Whether Burkholderia cepacia complex should be an objectionable organism in antiseptic solutions with acceptable total bacterial counts is controversial. By using next-generation sequencing, we documented a polyclonal B. cepacia complex outbreak affecting peritoneal dialysis patients in Hong Kong that was caused by contaminated chlorhexidine solutions. Epidemiologic investigations at a manufacturing site identified a semiautomated packaging machine as the probable source of contamination in some of the brands. Use of whole-genome sequencing differentiated the isolates into 3 brand-specific clonal types. Changes in exit site care recommendations, rapid recall of affected products, and tightening of regulatory control for chlorhexidine-containing skin antiseptics could prevent future similar outbreaks. Environmental opportunistic pathogens, including B. cepacia complex, might be included in regular surveillance as indicator organisms for monitoring environmental contamination.

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Section: Discussioncontrasting

confidence: 63%

Polyclonal Burkholderia cepacia Complex Outbreak in Peritoneal Dialysis Patients Caused by Contaminated Aqueous Chlorhexidine

Wong¹,

Wong²,

Chen³

et al. 2020

Emerg. Infect. Dis.

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“…72 A Burkholderia cepacia outbreak, in which 12 neonates developed clinical and/or laboratory evidence of sepsis was traced to contaminated IV solution and water for humidification of ventilator circuits. 73 A cluster of Bacillus cereus colitis cases, 74 an extended-spectrum beta-lactamase E. coli outbreak, 75 and case reports of GBS septicemia in preterm infants 76 have all been attributed to contaminated breast milk. Cronobacter species have been identified as a contaminant of powdered milk formulas, with sporadic outbreaks linked to necrotizing enterocolitis, bacteremia, and meningitis.…”

Section: The Microbiota and Disease Risk In Extremely Preterm Infantsmentioning

confidence: 99%

The Microbiota of the Extremely Preterm Infant

Underwood

Sohn

2017

Clinics in Perinatology

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Colonization of the extremely preterm infant's gastrointestinal tract and skin begins in utero and is influenced by a variety of factors, the most important including gestational age and environmental exposures. The composition of the intestinal and skin microbiota influences the developing innate and adaptive immune responses with short-term and long-term consequences including altered risks for developing necrotizing enterocolitis, sepsis, and a wide variety of microbe-related diseases of children and adults. Alteration of the composition of the microbiota to decrease disease risk is particularly appealing for this ultra-high-risk cohort that is brand new from an evolutionary standpoint.

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“…7 Burkholderia cepacia infections in intensive care units are associated with many factors such as pneumonia, bacteremia, skin and soft tissue infection, urethral genitourinary tract infection, or exposure to contaminated solutions. 8 In our study, incubator humidification solutions were found as the source of the bacteria. An outbreak in the neonatal intensive care unit was prevented by early detection of the agent and the immediate replacement of humidification solutions.…”

Section: Discussionmentioning

confidence: 90%

Humidification Solution as a Source for Spreading Burkholderia cepacia in a Neonatal Intensive Care Unit

Baysal

2020

Journal of Pediatric Infectious Diseases

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Burkholderia cepacia is an important opportunistic organism in hospitalized and immunocompromised patients especially in newborns. The natural ecology of these bacteria associated with plants is also a cause of infectious potential. The disease-causing potential of bacteria as a nosocomial pathogen may be due to its ability to survive in antiseptic solutions, contamination equipment. The patient was hospitalized for prematurity and respiratory distress syndrome. He was treated with surfactant intratracheally for the respiratory distress syndrome. Umbilical catheter was inserted. Ampicillin and gentamicin treatments were initiated. The patient who received respiratory support for a long time was given a steroid protocol because of bronchopulmonary dysplasia. Burkholderia cepacia was detected in the blood and tracheal aspirate cultures of the patient, whose infection markers increased and a new area of infection was detected on the chest radiograph. Colistin and ciprofloxacin treatments were given according to the culture antibiogram. Screening tests revealed B. cepacia colonization in incubator moistening solutions. All incubator humidification solutions in the hospital were changed. Burkholderia cepacia is a rare cause of nosocomial infection in intensive care units but resistant to many treatments. With its capability to colonize water and grow on microbicides, the presence of B. cepacia in a patient's blood warrants further investigation in institutions providing care.

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An Outbreak of Burkholderia cepacia Bacteremia in a Neonatal Intensive Care Unit

Abstract: The investigations revealed the source of the nosocomial outbreak which is crucial for initiating appropriate control measures.

Cited by 24 publications

References 23 publications

Polyclonal Burkholderia cepacia Complex Outbreak in Peritoneal Dialysis Patients Caused by Contaminated Aqueous Chlorhexidine

Polyclonal Burkholderia cepacia Complex Outbreak in Peritoneal Dialysis Patients Caused by Contaminated Aqueous Chlorhexidine

The Microbiota of the Extremely Preterm Infant

Humidification Solution as a Source for Spreading Burkholderia cepacia in a Neonatal Intensive Care Unit

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