A Burkholderia contaminans outbreak in an intensive care unit associated with contaminated bath solution: Control and microbiological findings

IF 2.4 3区医学 Q2 INFECTIOUS DISEASES American journal of infection control Pub Date : 2025-03-01 Epub Date: 2024-10-22 DOI:10.1016/j.ajic.2024.10.006

Daniela Kallíope de Sá Paraskevopoulos MD , Carlos Henrique Camargo MsC, PhD , Priscila Koba Kodato MsC , Amanda Yaeko Yamada MsC , Adriana Aparecida Buzzo Almodovar MsC , Ellen Gameiro Hilinski MsC , Alexandre Inácio de Paula MsC , Elaine Fernanda Irineu MsC , Sandra Rodrigues Barrio MsC , Cibele L. Fonseca MD , Cristiano de Melo Gamba MD , Nair Hosino MD , Augusto Yamaguti MD , João S. de Mendonça MD, PhD , Thaís Guimarães MD, PhD

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Abstract

Background

The Burkholderia cepacia complex comprises a group of bacteria with a growing threat as a contaminant of nonsterile solutions. We describe an outbreak of a Burkholderia cepacia complex involving patients at intensive care unit related to a no-rinse bathing solution (NRBS).

Methods

We carried out patients, environmental and laboratory investigation performing analyses of cases, pulsed-field-gel electrophoresis and whole genome sequence (WGS) of isolates.

Results

We investigated 32 cases and 16 isolates that were identified as Burkholderia contaminans, belonging to 2 different clones. One clone (new ST2175) was identified in 6 sequences (4 from patients and 2 from bath cart samples) and for the remaining 10 isolates (7 isolates from patients and 3 from NRBS) we identified the ST762. The investigation demonstrated that NRBS was the source of the outbreak caused by ST762 clone of B contaminans.

Discussion

Early suspicion of a common source, rapid implementation of control measures, and laboratory support are vital in an outbreak investigation. We also highlight the role of WGS which was very important to conclude our investigation regarding environmental samples and bacterial typing.

Conclusions

We highlight the need to regulate water-based products and the role of WGS for investigate environmental samples.

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重症监护室爆发的伯克霍尔德氏菌污染与受污染的浴液有关：控制和微生物学发现。

背景：伯克霍尔德氏菌复合菌（BCC）是一组细菌，作为非无菌溶液的污染物，其威胁日益严重。我们描述了一起涉及重症监护病房患者的伯克霍尔德氏头孢菌素复合菌（BCC）疫情，该疫情与免洗浴液（NRBS）有关：我们对患者、环境和实验室进行了调查，对病例进行了分析，对分离物进行了脉冲-场凝胶电泳和全基因组测序（WGS）：结果：我们调查了 32 个病例和 16 个分离株，确定它们为污染伯克霍尔德氏菌，属于两个不同的克隆。其中一个克隆（新的 ST2175）在 6 个序列（4 个来自患者；2 个来自浴车样本）中被确定，而在其余 10 个分离物（7 个来自患者；3 个来自 NRBS）中，我们确定了 ST762。调查结果表明，NRBS 是由污染杆菌 ST762 克隆引起的疫情爆发源：讨论：在疫情调查中，及早怀疑共同来源、快速实施控制措施和实验室支持至关重要。我们还强调了 WGS 的作用，它对我们完成环境样本和细菌分型调查非常重要：我们强调了对水基产品进行监管的必要性以及 WGS 在调查环境样本中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)