Nosocomial outbreak of two strains of Burkholderia cepacia caused by contaminated heparin

Yang, Chih‐Jen; Chen, Tsung-Chi; Liao, Linhong; Ma, Liang; Wang, C.-S.; Lu, Po‐Liang; Chen, Y.-H.; Jang, Hwan; Siu, L. Kristopher; Huang, Meei-Feng

doi:10.1016/j.jhin.2008.03.011

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…However, there was an outbreak of B. cepacia due to contaminated multiple-dose heparin vials [19]. In addition, our study showed that MRSA led to the highest inappropriate antibiotic use (80.6%) and the highest in-hospital mortality rate (64.5%) among all pathogens.…”

Section: Discussionmentioning

confidence: 75%

“…The most common pathogens in the study were E. coli (42 cases), K. pneumoniae (34 cases), MRSA (31 cases), and Burkholderia cepacia (23 cases). There was an outbreak of B. cepacia infection in the hospital between 2006 and 2007 [19]. The pathogens with mortality rates of more than 50% included MRSA , coagulase negative Staphylococcus , Streptococcus pneumoniae, Viridans Streptococcus, Enterococcus faecalis, Klebsiella pneumoniae, Enterobacter aerogenes, Serratia marcescens, Citrobacter spp.…”

Section: Resultsmentioning

confidence: 99%

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The impact of inappropriate antibiotics on bacteremia patients in a community hospital in Taiwan: an emphasis on the impact of referral information for cases from a hospital affiliated nursing home

et al. 2013

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BackgroundEvidence for the impact of inappropriate antimicrobial therapy on bacteremia is mainly from studies in medical centers. We investigated the impact of inappropriate antimicrobial therapy on bacteremia in a community hospital. In particular, patients from the hospital’s affiliated nursing home were sent to the hospital with adequate referral information.MethodsWe performed a retrospective study to collect data of patients with bacteremia in a community hospital in Taiwan from 2005 to 2007.ResultsA total of 222 patients with blood stream infection were diagnosed, of whom 104 patients (46.8%) died. The rate of initial inappropriate antibiotic prescriptions was high (59%). Multivariate analysis revealed that patients with initial inappropriate antibiotics, patients with ventilator support and patients requiring ICU care were the independent predictors for inhospital mortality. Patients referred from the hospital-affiliated nursing home and patients with normal WBC counts had better survival outcome. More than 80% cases infected with methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus faecalis received initial inappropriate antimicrobial therapy. With the longer delay to administer appropriate antibiotic, a trend of higher mortality rates was observed.ConclusionsBacteremia patients from a hospital-affiliated nursing home had a better prognosis, which may have been due to the adequate referral information. Clinicians should be aware of the commonly ignored drug resistant pathogens, and efforts should be made to avoid delaying the administration of appropriate antibiotic therapy.

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Section: Discussionmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

The impact of inappropriate antibiotics on bacteremia patients in a community hospital in Taiwan: an emphasis on the impact of referral information for cases from a hospital affiliated nursing home

et al. 2013

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“…A review of FDA product recalls (1998 to 2006) reported B. cepacia as the most frequently isolated Gramnegative contaminant of sterile and nonsterile pharmaceuticals (3). Outbreaks of Bcc infection in vulnerable individuals have resulted from the use of contaminated antimicrobial/preserved industrial products (7)(8)(9)(10). Burkholderia contaminans (11) was given its systematic species name because of its linkage to a globally distributed strain associated with multiple incidents of contamination and opportunistic infection (12).…”

mentioning

confidence: 99%

Key Role for Efflux in the Preservative Susceptibility and Adaptive Resistance of Burkholderia cepacia Complex Bacteria

Rushton

Saß

Baldwin

et al. 2013

Antimicrob Agents Chemother

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“…Moreover, unfractionated heparin is dispensed in multiple-dose vials, which are potentially vulnerable to contamination [58]. Besides its greater cost, a relative disadvantage of LMWH at the time of delivery is its longer halflife, which is an important consideration for both neuraxial anesthesia and peripartum bleeding risk.…”

Section: Heparin Management During Pregnancymentioning

confidence: 99%

Anticoagulant Therapy During Pregnancy for Maternal and Fetal Acquired and Inherited Thrombophilia

Giannubilo

Al²

2012

CMC

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Thromboembolism is an infrequent, yet serious cause of both maternal and fetal morbidity and death during pregnancy and the puerperium. Antithrombotic treatment and prophylaxis both before and during pregnancy are based on unfractionated heparin (UH), low-molecularweight heparin (LMWH), Warfarin and Aspirin. The prevalence and severity of thromboembolism during pregnancy and puerperium warrant special consideration of management and therapy. Such therapy includes the treatment of acute thrombotic events and prophylaxis for those at increased risk of thrombotic events. This paper assesses the safety and efficacy of antithrombotic therapy during pregnancy and the peripartum period. Its cardiovascular and obstetric indications, the evidence of association between thrombophilias and adverse pregnancy outcome, regimens and maternal and fetal side-effects are also discussed.

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Nosocomial outbreak of two strains of Burkholderia cepacia caused by contaminated heparin

Cited by 16 publications

References 7 publications

The impact of inappropriate antibiotics on bacteremia patients in a community hospital in Taiwan: an emphasis on the impact of referral information for cases from a hospital affiliated nursing home

The impact of inappropriate antibiotics on bacteremia patients in a community hospital in Taiwan: an emphasis on the impact of referral information for cases from a hospital affiliated nursing home

Key Role for Efflux in the Preservative Susceptibility and Adaptive Resistance of Burkholderia cepacia Complex Bacteria

Anticoagulant Therapy During Pregnancy for Maternal and Fetal Acquired and Inherited Thrombophilia

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