Investigation of an outbreak of Burkholderia cepacia infection caused by drug contamination in a tertiary hospital in China

Zou, Qi; Li, Na; Liu, Juyuan; Li, Xin; Wang, Zhuofei; Xiaoman, Ai; FengRong, Tao; Qu, Mei; Cai, Meng; Hu, Yunjian

doi:10.1016/j.ajic.2019.06.011

Cited by 16 publications

(14 citation statements)

References 13 publications

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“…Additional articles were added using the reference lists from each retrieved report. The time frame regarding publication ranged from 1971 [ 10 ] to 9/12/2019 [ 11 ]. Figure 1 summarizes the review process.…”

Section: Methodsmentioning

confidence: 99%

Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control

Häfliger

Atkinson

Marschall

2020

Infection Prevention in Practice

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Summary Background Over the past decades, the Burkholderia cepacia complex (BCC) has been linked to multiple healthcare-associated outbreaks. No systematic analysis of these outbreaks has been carried out to date. The aim of this study was to conduct a systematic review of reports on nosocomial BCC outbreaks. Methods Published studies from 1971 until 9/12/2019 presenting nosocomial BCC outbreaks were identified using Embase, Pubmed and abstracts from professional meetings. Results We identified a total of 111 outbreak reports. Thirty-two percent of the affected institutions were academic hospitals and 43.8% community hospitals. The average outbreak duration was 198.6 ± 604.4 days. A total of 240 deaths (10% of the 2390 case patients) were reported but only 28 (1.2% of the 2390 case patients and 11.7% of the 240 deaths) were directly attributable to BCC. The source could be identified in 73.9% of the outbreaks; 53.2% were caused by contaminated medical solutions and medications, 12% were due to a contaminated disinfectant. In 28.2% of the outbreaks intrinsic product contamination was reported. Multidrug resistance was noted in 26.1% of the BCC strains. PFGE was the most frequently used typing method (43.2%) in the context of outbreak work-up. Conclusion Medical products are the most frequent source of BCC outbreaks, representing over half of the identified sources, with 12% of the outbreaks caused by disinfectant products. Intrinsic product contamination was detected frequently, suggesting a need for stricter regulation. While BCC-related mortality was low, our systematic review revealed significant heterogeneity in both investigations and reporting of BCC outbreaks.

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Section: Methodsmentioning

confidence: 99%

Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control

Häfliger

Atkinson

Marschall

2020

Infection Prevention in Practice

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“…They isolated the 11 isolates of B. cepacia in 4 hospitals and identified the point source as the contaminated gel packs in sachets used in the sterile ultrasound probe covers [ 16 ]. A recent outbreak report showed that contaminated analgesic gel used in urological procedures caused B. cepacia bacteremia in nine patients [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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

Bilgin

Gelmez

Bayrakdar³

et al. 2021

Antimicrob Resist Infect Control

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Background We report a nosocomial outbreak caused by Burkholderia cepacia that occurred among six patients admitted in the medical and surgical intensive care unit between 04 March 2019 and 02 April 2019 in Istanbul, Turkey. Methods The outbreak investigation was launched on 11 March 2019 five days after the detection of B. cepacia in four different patients. We defined potential reservoirs and started environmental screening. We sampled the liquid solutions used in patient care activities. Pulse-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness of environmental and patient samples. Results Burkholderia cepacia was isolated in tracheal aspiration cultures of six patients. Three out of six patients developed healthcare-associated pneumoniae due to B. cepacia. Environmental cultures in the ICUs revealed B. cepacia growth in 2% chlorhexidine-gluconate mouthwash solution that been used in the colonized patients as well as in samples obtained from the unused products. PFGE revealed the patient and a specific batch of chlorhexidine mouthwash solution samples had a 96% similarity. Conclusion Contamination of medical solutions used in critical patient care could cause outbreaks and should be detected early by infection control teams. Graphic abstract

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“…They isolated the 11 isolates of B. cepacia in 4 hospitals and identi ed the point source as the contaminated gel packs in sachets used in the sterile ultrasound probe covers [15]. A recent outbreak report showed that contaminated analgesic gel used in urological procedures caused B. cepacia bacteremia in nine patients [16]. This outbreak emphasizes the potential consequences of B. cepacia in critical patients, particularly in intensive care units.…”

Section: Discussionmentioning

confidence: 99%

An Outbreak Investigation of Burkholderia Cepacia Infections Related With Contaminated Chlorhexidine Mouthwash Solution in a Tertiary Care Center in Turkey.

Bilgin

Gelmez

Bayrakdar

et al. 2021

Preprint

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Background: We report a nosocomial outbreak caused by Burkholderia cepacia that occurred among six patients admitted in the medical and surgical intensive care unit between 04 March 2019 and 02 April 2019 in Istanbul, Turkey. Methods: The outbreak investigation was launched on 11 March 2019 five days after the detection of B. cepacia in four different patients. We defined potential reservoirs and started environmental screening. We sampled the liquid solutions used in patient care activities. Pulse-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness of environmental and patient samples.Results: B. cepacia was isolated in tracheal aspiration cultures of six patients. Three out of six patients developed healthcare-associated pneumoniae due to B. cepacia. Environmental cultures in the ICUs revealed B. cepacia growth in 2% chlorhexidine-gluconate mouthwash solution that been used in the colonized patients as well as in samples obtained from the unused products. PFGE revealed the patient and a specific batch of chlorhexidine mouthwash solution samples had a 96% similarity. Conclusion: Contamination of medical solutions used in critical patient care could cause outbreaks and should be detected early by infection control teams.

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Investigation of an outbreak of Burkholderia cepacia infection caused by drug contamination in a tertiary hospital in China

Cited by 16 publications

References 13 publications

Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control

Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control

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

An Outbreak Investigation of Burkholderia Cepacia Infections Related With Contaminated Chlorhexidine Mouthwash Solution in a Tertiary Care Center in Turkey.

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