An outbreak investigation of bacteraemia due to Burkholderia cepacia complex at the National Hospital of Sri Lanka

Abstract

Burkholderia cepacia complex (BCC) is an opportunistic pathogen in immunocompromised patients and well distributed in the natural environment. Nosocomial outbreaks of BCC are due to contaminated solutions and medical devices. However, in Sri Lanka, there have been no nosocomial outbreaks of BCC reported in the past. We report here an outbreak investigation of bacteraemia due to BCC in the wards and ICUs of the National Hospital of Sri Lanka (NHSL) during the period of August 14 th 2017 to September 13 th 2017 which an extensive investigation traced to a contaminated nebulizer solution of a particular brand of ipratropium bromide. The blood culture isolates from the patients with bacteraemia and from the particular nebulizer solution were found to be identical and confirmed as BCC. There had been outbreaks in other hospitals with the same organism in the recent past but they were not able to find the common source for the outbreak. The incident was reported officially to the relevant authorities and other hospitals, and an alternative agent for the use of nebulization was strongly recommended to prevent further cases immediately.

Burkholderia Cepacia: An Emerging Superbug in Intensive Care Unit Settings of Tertiary Care Hospitals in Pakistan

“…However, here we see a steady increase in isolation of this bacterium mainly because of our better diagnostic facilities and gaps in infection control practices. 15 The spectrum of B.cepacia infections among patients of various units of this institute was assessed in this study. A high percentage of B.cepacia were isolated from specimens of patients admitted in medical intensive care units and surgical intensive care units, followed by Paediatric intensive care units, neonatal intensive care units, and wards like medical orthopaedic and pediatric wards.…”

“…This observation is quite homologous to other studies undertaken in various regions across the biosphere. 5,15 BCC causes a spectrum of clinical infections that include bacteremia, respiratory tract infections, urinary tract infections, joint infections, and abdominal infections. 16 The specimen from where the isolate was most frequently identified as blood cultures.…”