Intrinsically Contaminated Alcohol-Free Mouthwash Implicated in a Nosocomial Outbreak of <i>Burkholderia cepacia</i> Colonization and Infection

Molina‐Cabrillana, Jesús; Bolaños-Rivero, Margarita; Álvarez-León, Eva E.; Sánchez, Antonio Manuel Martı́n; Sánchez-Palacios, Manuel; Álvarez, David; Sáez-Nieto, Juan Antonio

doi:10.1086/508845

Cited by 31 publications

(18 citation statements)

References 9 publications

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“…342,343 Many healthcareassociated outbreaks of Burkholderia infections associated with contaminated skin antiseptics, mouthwashes, ultrasound gels, medications, and medical devices have been described. [344][345][346][347][348][349][350][351][352][353][354][355][356][357][358][359][360][361][362] Other products that have become contaminated during use include nasal irrigation bottles contaminated with P. aeruginosa, 363,364 multiuse albuterol vials contaminated with B. cepacia, 348,357 acupuncture devices disinfected with glutaraldehyde contaminated with M. abscessus, 365 cosmetic surgical supplies contaminated with mycobacterial spp., and supplies used for liposuction. 366 Outbreaks of Achromobacter spp.…”

Section: Iiid2 Healthcare Sources: Water Surfaces Equipment Airmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

344

382

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The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.

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Section: Iiid2 Healthcare Sources: Water Surfaces Equipment Airmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

344

382

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“…Other studies have showed that the presence of B. cepacia in products used for mouth hygiene has frequently been implicated in B. cepacia infection [29][30][31]. Contamination of cosmetics and pharmaceuticals with B. cepacia is also a frequent problem in the United States and it is a cause of major product recalls [32][33][34].…”

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confidence: 99%

Microbiologically Contaminated and Over-Preserved Cosmetic Products According Rapex 2008–2014

Neza

Centini

2016

Cosmetics

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Abstract:We investigated the Rapid Alert System (RAPEX) database from January 2008 until week 26 of 2014 to give information to consumers about microbiologically contaminated cosmetics and over-preserved cosmetic products. Chemical risk was the leading cause of the recalls (87.47%). Sixty-two cosmetic products (11.76%) were recalled because they were contaminated with pathogenic or potentially pathogenic microorganisms. Pseudomonas aeruginosa was the most frequently found microorganism. Other microorganisms found were: Mesophilic aerobic microorganisms, Staphylococcus aureus, Candida albicans, Enterococcus spp., Enterobacter cloacae, Enterococcus faecium, Enterobacter gergoviae, Rhizobium radiobacter, Burkholderia cepacia, Serratia marcescens, Achromabacter xylosoxidans, Klebsiella oxytoca, Bacillus firmus, Pantoea agglomerans, Pseudomonas putida, Klebsiella pneumoniae and Citrobacter freundii. Nine cosmetic products were recalled because they contained methylisothiazolinone (0.025%-0.36%), benzalkonium chloride (1%), triclosan (0.4%) in concentrations higher than the limits allowed by European Regulation 1223/2009. Fifteen products were recalled for the presence of methyldibromo glutaronitrile, a preservative banned for use in cosmetics. Thirty-two hair treatment products were recalled because they contained high concentrations of formaldehyde (0.3%-25%).

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“…2, types B1, B3, B4, B8, B9 and B13) suggests that pathogen acquisition might be via the environment, in which Bcc is ubiquitous [1], or from contaminated products used in hospitals. In this regard, hospital infections of patients with CF [16] and certain immunocompromising conditions [17] have been described as associated with the use of healthcare products.…”

Section: Discussionmentioning

confidence: 99%

Increase in isolation of Burkholderia contaminans from Spanish patients with cystic fibrosis

Medina

Valdezate

Carrasco

et al. 2015

Clinical Microbiology and Infection

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Species of the Burkholderia cepacia complex are associated with opportunistic infection in patients with cystic fibrosis. For years now, B. multivorans and B. cenocepacia have been the most frequently isolated species within the complex in such patients. However, between 2008 and 2012, the overall incidence of these species in Spain (17.7% and 12.5% respectively) was overtaken by that of B. contaminans (36.5%). The population structure of B. contaminans isolates from Spanish patients with cystic fibrosis was analysed using multilocus sequence typing and pulsed-field gel electrophoresis (PFGE). Three major known sequence types (ST102, ST404 and ST482) and a new one (ST771) were identified among 59 isolates. In addition, PFGE detected 17 pulsotypes. Susceptibility to antibiotics was examined using the Etest. Cotrimoxazole and ceftazidime were the most active antibiotics against B. contaminans, inhibiting growth in 88% and 86% of the isolates, respectively. In addition, this species showed less resistance to most of the antibiotics tested than did either B. multivorans or B. cenocepacia isolates recovered from similar Spanish patients.

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Intrinsically Contaminated Alcohol-Free Mouthwash Implicated in a Nosocomial Outbreak of Burkholderia cepacia Colonization and Infection

Cited by 31 publications

References 9 publications

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Microbiologically Contaminated and Over-Preserved Cosmetic Products According Rapex 2008–2014

Increase in isolation of Burkholderia contaminans from Spanish patients with cystic fibrosis

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