Suspicious outbreak of ventilator-associated pneumonia caused by Burkholderia cepacia in a surgical intensive care unit

Guo, Liping; Li, Gang; Wang, Jian; Zhao, Xinshu; Wang, Shupeng; Zhai, Li; Jia, Hongbin; Cao, Bin

doi:10.1016/j.ajic.2017.01.024

Cited by 8 publications

(9 citation statements)

References 18 publications

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“…Oropharyngeal bacterial colonization during intubation and poor cough reflex may contribute to the development of pneumonia (Gomes-Filho et al, 2010). The association with mechanical ventilation has been described in previous outbreaks (Guo et al, 2017;Zurita et al, 2014).…”

Section: Discussionmentioning

confidence: 97%

Epidemiological investigation and successful management of a Burkholderia cepacia outbreak in a neurotrauma intensive care unit

Rastogi

Khurana

Veeraraghavan

et al. 2019

International Journal of Infectious Diseases

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Objective: The detailed epidemiological and molecular characterization of an outbreak of Burkholderia cepacia at a neurotrauma intensive care unit of a level 1 trauma centre is described. The stringent infection control interventions taken to successfully curb this outbreak are emphasized. Methods: The clinical and microbiological data for those patients who had more than one blood culture that grew B. cepacia were reviewed. Bacterial identification and antimicrobial susceptibility testing was done using automated Vitek 2 systems. Prospective surveillance, environmental sampling, and multilocus sequence typing (MLST) were performed for extensive source tracking. Intensive infection control measures were taken to further control the hospital spread. Results: Out of a total 48 patients with B. cepacia bacteraemia, 15 (31%) had central line-associated blood stream infections. Two hundred and thirty-one environmental samples were collected and screened, and only two water samples grew B. cepacia with similar phenotypic characteristics. The clinical strains characterized by MLST typing were clonal. However, isolates from the water represented a novel strain type (ST-1289). Intensive terminal cleaning, disinfection of the water supply, and the augmentation of infection control activities were done to curb the outbreak. A subsequent reduction in bacteraemia cases was observed. Conclusion: Early diagnosis and appropriate therapy, along with the rigorous implementation of essential hospital infection control practices is required for successful containment of this pathogen and to curb such an outbreak.

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Section: Discussionmentioning

confidence: 97%

Epidemiological investigation and successful management of a Burkholderia cepacia outbreak in a neurotrauma intensive care unit

Rastogi

Khurana

Veeraraghavan

et al. 2019

International Journal of Infectious Diseases

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“…Burkholderia multivorans and B. cenocepacia are most often associated with Bcc infections in humans, particularly cystic fibrosis patients . Contaminated medical devices and medications have been associated with nosocomial outbreaks . Bcc infections present a clinical challenge due to frequent antimicrobial resistance, which may be both intrinsic and acquired .…”

Section: Introductionmentioning

confidence: 99%

Clinical and histopathological features of Burkholderia cepacia complex dermatitis in dogs: a series of four cases

Cain

Cole

Bradley

et al. 2018

Veterinary Dermatology

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“…Published literature on B. cepacia ESIs is limited to a single case report and 1 series of 22 cases over 10 years (2,3). Nosocomial outbreaks have been reported in intensive care and hemodialysis units but never before in a PD unit (4–6). As in our cases, previous literature has often implicated chlorhexidine as a source in nosocomial outbreaks (7,8).…”

Section: Discussionmentioning

confidence: 99%

Burkholderia cepacia: An Outbreak in the Peritoneal Dialysis Unit

et al. 2019

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Burkholderia cepacia is a ubiquitous, opportunistic, environmental gram-negative bacillus which most commonly affects cystic fibrosis and immunocompromised patients. Rarely, it can cause peritoneal dialysis (PD) exit-site infection (ESI). Information relating to predisposing factors, clinical course, and treatment options for B. cepacia ESIs is limited. Although reports of B. cepacia healthcare-associated infections exist, outbreaks in PD units have not previously been reported. A recent outbreak of B. cepacia ESI in our PD unit provided a unique opportunity to study B. cepacia ESIs and to outline an approach to investigating such an outbreak. After unexpectedly identifying B. cepacia as the cause of PD catheter ESIs in 3 patients over an 11-week period, we began systematically screening our PD population for B. cepacia exit-site colonization. A further 6 patients were found to be affected, 3 with asymptomatic colonization and 3 with symptomatic B. cepacia ESI. Four of the 6 developed tunnel infections requiring multiple courses of antibiotic treatment, and 3 patients required catheter removal; 2 patients with symptomatic ESIs without tunnel involvement responded to oral and topical antibiotics. Further investigation implicated 4% chlorhexidine aqueous bodywash used by all patients as the probable source of the outbreak. This is the first reported outbreak of B. cepacia ESIs. We noted an association between diabetes mellitus and refractory/more extensive infection. Our experience suggests that isolated ESIs can be treated successfully with oral antibiotics whereas tunnel infections generally require catheter removal.

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Suspicious outbreak of ventilator-associated pneumonia caused by Burkholderia cepacia in a surgical intensive care unit

Cited by 8 publications

References 18 publications

Epidemiological investigation and successful management of a Burkholderia cepacia outbreak in a neurotrauma intensive care unit

Epidemiological investigation and successful management of a Burkholderia cepacia outbreak in a neurotrauma intensive care unit

Clinical and histopathological features of Burkholderia cepacia complex dermatitis in dogs: a series of four cases

Burkholderia cepacia: An Outbreak in the Peritoneal Dialysis Unit

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