Nosocomial bloodstream infections with Burkholderia stabilis

An outbreak of Burkholderia cenocepacia bacteremia in immunocompromised oncology patients

“…All patients recovered following removal of the central catheter together with ceftazidime therapy. In contrast to our observation of no mortality, the overall case fatality rate of Bcc bacteremia reported in the literature is high (11-100%) [12,14,[16][17][18]. Despite the tendency of certain Bcc species to cause severe disease among CF patients, a similar association could not be found in Bcc nosocomial infections; the mortality rate varied from 0 to 100% in two different outbreaks due to B. stabilis bacteremia [14,19].…”

“…Outbreaks or pseudo-outbreaks due to Gram-negative environmental species have been reported, and Bcc were recognized as the cause of nosocomial infections in at least a few occasions [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Most reports documented nosocomial transmission of Bcc in CF patients associated with contaminated respiratory equipment and via person-toperson [35].…”

“…In addition, Bcc were reportedly transmitted in CF summer camps [36]. However, in non-CF patients, some outbreaks were described among patients undergoing long-term dialysis [7,13,17,20] and among patients hospitalized in intensive care units [8,9,14,15,23] as well as in oncology departments [3,18,19]. Bcc outbreaks were previously traced to contaminated products in the hospital, including tap, distilled, or deionized water [11], chlorhexidine [7,19,20], and quaternary ammonium solutions [17].…”

“…Although the environmental investigation in the current outbreak was performed according to routine published methods [31], we did not use an enrichment broth containing selected carbon sources and antimicrobials or O/F agar for the isolation of Bcc, as was suggested by Vermis et al [37]. Furthermore, despite extensive epidemiologic investigation, the source of infection is often not identified [9,12,14].…”

“…Bcc are emerging pathogens among cystic fibrosis (CF) patients [2], and their resistance to disinfectants and antiseptics is blamed for them becoming hospital-acquired pathogens [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The clinical syndromes of Bcc infection range from asymptomatic carriage to necrotizing granulomatous pneumonia in CF patients [2], and bacteremia or pneumonia among hospitalized patients [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Most patients acquiring Bcc bacteremia have serious co-morbidities such as chronic hemodialysis, diabetes mellitus, congestive heart failure, and malignancy.…”