Case-Crossover Study of Burkholderia cepacia Complex Bloodstream Infection Associated with Contaminated Intravenous Bromopride

Abstract

Our investigation, using a case-crossover design, of an outbreak of BCC-BSI infections concluded it was polyclonal but likely caused by infusion of contaminated bromopride. The epidemiological finding was validated by microbiological analysis. After recall of contaminated bromopride vials by the manufacturer, the outbreak was controlled.

Case‐crossover study design in pharmacoepidemiology: systematic review and recommendations

“…Of 836 unique articles identified, 99 pharmacoepidemiologic studies were eligible: 20 methodological contributions, 9 review papers, and 70 empirical applications, Figure . Of the 70 pharmacoepidemiologic empirical applications, 47% were identified by all 3 searches, 36% were identified in both MEDLINE and EMBASE but not the Web of Science citation search, and 10% were identified uniquely from the Web of Science seminal paper citation search, Figure .…”

Pseudo-outbreak of Burkholderia cepacia blood stream infections in intensive care units of a super-speciality hospital: A cross-sectional study

“…These include contamination of ultrasound gel, albuterol solution for nebulization, water for injection, moisturizing body milk and IV bromopride, and antiemetic drug granisetron. [12,[16][17][18][19][20] Despite the fact that no source could specifically be found as the cause of this pseudo-outbreak, some infection control measures were implemented which included the following: Hand hygiene, chlorination of water supplied to ICUs and OTs, and proper cleaning of ICUs and OTs. Another practice which was specifically targeted was the use of a common needle inserted into rubber caps of multidose heparin vials through which separate sterile syringes were loaded.…”

Outbreak of Burkholderia cepacia complex bacteremia in a chemotherapy day care unit due to intrinsic contamination of an antiemetic drug

“…These include contamination of ultrasound gel, albuterol solution for nebulisation, water for injection, moisturising body milk and intravenous bromopride. [6][7][8][9][10] We acknowledge nonavailability of pulse fi eld gel electrophoresis (PFGE) or multilocus sequence typing (MLST) as a limitation in proving clonal relatedness of all isolates. However, identical susceptibility patterns, identifi cation of a single common source and cessation of the outbreak after withdrawing the incriminated medication are reasonable indirect evidence of a common source outbreak.…”