Outbreak of Burkholderia Cepacia Infection: A Systematic Study in a Hematology-Oncology Unit of a Tertiary Care Hospital From Eastern India.

Baul, Shuvra Neel; De, Rajib; Mandal, Prakas Kumar; Roy, Swagnik; Dolai, Tuphan Kanti; Chakrabarti, Prantar

doi:10.4084/mjhid.2018.051

Cited by 24 publications

(20 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent outbreaks of Bcc bacteraemia from India, Germany and USA, have been reported particularly in the immunocompromised patients [6,[10][11][12]. Bcc outbreaks are always linked to hospital environment and/or contaminated medical devices, intravenous fluids or antiseptic solutions [4][5][6][10][11][12][13]. We describe an outbreak of B. cepacia bacteraemia in burn's critical care units of Dhaka Medical College Hospital (DMCH) analysed by whole genome sequencing.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

et al. 2020

View full text Add to dashboard Cite

Background Burkholderia cepacia complex (Bcc) is a group of serious pathogens in cystic fibrosis patients and causes life threatening infections in immunocompromised patients. Species within the Bcc are widely distributed within the environment, can survive in the presence of disinfectants and antiseptics, and are inherently multidrug resistant (MDR). Methods Dhaka Medical College Hospital (DMCH) patients with a B. cepacia positive blood culture between 20 October 2016 to 23 rd September 2017 were considered as outbreak cases. Blood stream infections (BSIs) were detected using BacT/ALERT 3D at DMCH. B. cepacia was isolated on chromogenic UTI media followed by MALDI-TOF. Minimum inhibitory concentration (MIC) of clinically relevant antibiotics was determined by agar dilution. Whole genome sequencing was performed on an Illumina MiSeq platform. Patients' demographic and clinical data were collected. Patients' clinical history and genomic data of the outbreak strains were merged to investigate possible outbreaks. Ninety-one B. cepacia genomes were downloaded from 'Burkholderia Genome Database' and the genomic background of the global strains were compared with our outbreak strains. Results Among 236 BSIs, 6.35% (15/236) were B. cepacia. Outbreak cases were confined to the burn critical care unit and, to a lesser extent, the paediatrics department. There was a continuum of overlapping cases at DMCH between 23 October 2016 to 30 August 2017. Core genome SNPs showed that the outbreak strains were confined to a single clade, corresponded to a common clone (ST1578). The strains were shown to be MDR and associated with a mortality of 31% excluding discharge against medical advice. MIC profiles of the PLOS NEGLECTED TROPICAL DISEASES

show abstract

Section: Introductionmentioning

confidence: 99%

“…It is disconcerting that antibiotic pressure might have enhanced the elevation in antibiotic resistance during the outbreak [35,36]. Identification of environmental sources of the outbreak followed by patient management can reduce the risk of infections in vulnerable populations [4][5][6][10][11][12][13]29].…”

mentioning

confidence: 99%

Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

et al. 2020

View full text Add to dashboard Cite

show abstract

“…B. cepacia HAIs have been documented in patients from various age groups including neonates, [23][24][25][26] pediatric patients, [27][28][29][30][31][32] young adults, 33,34 adults [35][36][37][38][39] and ageing patients, 40,41 yet it is mostly reported in adults. Like many opportunistic pathogens, members of BCC affect immunocompromised individuals including patients affected with cystic fibrosis, 31,[42][43][44][45][46] patients with hematological diseases, 4,[47][48][49] postoperative patients, 36,50,51 and hemodialysis patients. 34,[52][53][54][55] This accounts for the predominance of reported outbreaks in adult, 12 pediatric, 29 and neonatal 25 intensive care units (ICUs), where mechanically ventilated patients are at an increased risk of HAI.…”

Section: Discussionmentioning

confidence: 99%

Global burden, point sources, and outbreak management of healthcare-associatedBurkholderia cepaciainfections: An integrative review

Shaban

Sotomayor-Castillo

Nahidi

et al. 2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Objective:To examine the global burden, associated point sources, and successful prevention and control measures for documented outbreaks of Burkholderia cepacia healthcare-associated infections (HAIs).Design:Integrative review.Methods:A review of all outbreaks of Burkholderia cepacia HAIs published in the peer-reviewed literature between January 1970 and October 2019 was conducted to identify the global burden, associated point sources, and successful prevention and control measures using the Guidelines for Outbreak Reports and Intervention Studies of Nosocomial Infections (ORION).Results:In total, we reviewed 125 documented outbreaks of Burkholderia cepacia–related HAIs worldwide. The reported B. cepacia HAIs for this period involved 3,287 patients. The point sources were identified in most outbreaks of B. cepacia HAIs (n = 93; 74.4%); they included medication vials, disinfectants, and antiseptics. Moreover, 95 of the outbreak reports (76%) described effective prevention and control measures, but only 33 reports indicated the use of a combination of environment-, patient- and staff-related measures. None of the outbreak reports used the ORION guidelines.Conclusions:Outbreaks of Burkholderia cepacia HAIs are an ongoing challenge. They are often associated with immunocompromised patients who acquire the infection from exposure to contaminated medications, products, and equipment. These outbreaks are not infrequent, and a range of infection prevention and control measures have been effective in arresting spread. The use of ORION guidelines for outbreak reporting would improve the quality of information and data to generate evidence for translation into practice.

show abstract

“…Given the difficulty in treating infections caused by non-fermenting Gramnegative bacilli, it is quite refreshing to note that S. maltophilia and A. hydrophilia were less isolated with little or no ARGS. aeruginosa in cystic fibrotic lungs, where they can cause persistent infections and death 10,60 .…”

Section: Discussionmentioning

confidence: 99%

Phylogeography and Resistome Epidemiology of Gram-Negative Bacteria in Africa: A Systematic Review and Genomic Meta-Analysis from a One-Health Perspective

Sekyere

Reta

2020

Preprint

View full text Add to dashboard Cite

Objectives/Backgrounds: Antibiotic resistance (ABR) remains a major threat to public health and infectious disease management globally. However, ABR ramifications in developing countries is worsened by limited molecular diagnostics, expensive therapeutics, inadequate skilled clinicians and scientists, and unsanitary environments. Methods: Data on specimens, species, clones, resistance genes, mobile genetic elements, and diagnostics were extracted and analysed from English articles published between 2015 and December 2019. The genomes and resistomes of the various species, obtained from PATRIC and NCBI, were analysed phylogenetically using RAxML and annotated with Figtree. The phylogeography of resistant clones/clades was mapped manually. Results & conclusion: Thirty species from 31 countries and 24 genera from 41 countries were respectively analysed from 146 articles and 3028 genomes. Genes mediating resistance to β-lactams (including blaTEM-1, blaCTX-M, blaNDM, blaIMP, blaVIM, blaOXA-48/181), fluoroquinolones (oqxAB, qnrA/B/D/S, gyrA/B and parCE mutations etc.), aminoglycosides (including armA, rmtC/F), sulphonamides (sul-1/2/3), trimethoprim (dfrA), tetracycline (tet(A/B/C/D/G/O/M/39)), colistin (mcr-1), phenicols (catA/B, cmlA), and fosfomycin (fosA) were mostly found in Enterobacter spp. and K. pneumoniae, and also in Serratia marcescens, Escherichia coli, Salmonella enterica, Pseudomonas, Acinetobacter baumannii, etc. on mostly IncF-type, IncX3/4, ColRNAI, and IncR plasmids, within IntI1 gene cassettes, insertion sequences and transposons. Clonal and multiclonal outbreaks and dissemination of resistance genes across species, countries and between humans, animals, plants and the environment were observed; E. coli ST103, K. pneumoniae ST101, S. enterica ST1/2 and V. cholerae ST69/515 were common strains. Most pathogens were of human origin and zoonotic transmissions were relatively limited. One Health studies in Africa are needed.

show abstract

Outbreak of Burkholderia Cepacia Infection: A Systematic Study in a Hematology-Oncology Unit of a Tertiary Care Hospital From Eastern India.

Cited by 24 publications

References 16 publications

Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

Molecular and epidemiological analysis of a Burkholderia cepacia sepsis outbreak from a tertiary care hospital in Bangladesh

Global burden, point sources, and outbreak management of healthcare-associatedBurkholderia cepaciainfections: An integrative review

Phylogeography and Resistome Epidemiology of Gram-Negative Bacteria in Africa: A Systematic Review and Genomic Meta-Analysis from a One-Health Perspective

Contact Info

Product

Resources

About