Hospital outbreak of Burkholderia stabilis bacteraemia related to contaminated chlorhexidine in haematological malignancy patients with indwelling catheters

• Published in: The Journal of hospital infection 2008-11, Vol.70 (3), p.241-245
• Main Authors: Heo, S.T, Kim, S.J, Jeong, Y.G, Bae, I.G, Jin, J.S, Lee, J.C
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Anti-Infective Agents, Local - adverse effects; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiseptics; Bacteremia - drug therapy; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteremia - prevention & control; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Burkholderia - isolation & purification; Burkholderia cepacia; Burkholderia Infections - drug therapy; Burkholderia Infections - epidemiology; Burkholderia Infections - microbiology; Burkholderia Infections - prevention & control; Burkholderia stabilis; Catheter-associated infection; Catheters, Indwelling - microbiology; Child; Chlorhexidine; Chlorhexidine - adverse effects; Chlorhexidine - analogs & derivatives; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Disease Outbreaks; Drug Contamination; Electrophoresis, Gel, Pulsed-Field; Female; General aspects; Hematologic Neoplasms - complications; Hospital outbreak; Hospitals, Teaching; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Infection Control - methods; Infectious Disease; Infectious diseases; Korea - epidemiology; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Young Adult
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2008.07.019

Summary Burkholderia cepacia complex (BCC) is an opportunistic pathogen that occasionally causes hospital outbreaks. This paper describes an outbreak of BCC bacteraemia in haematological malignancy patients related to a contaminated chlorhexidine gluconate solution. Eight BCC isolates were obtained from patients hospitalised in the same ward of a cancer centre in a Korean hospital. A further three BCC isolates were obtained from 0.5% chlorhexidine gluconate used in the same ward. The isolates were identified as B. stabilis and exhibited identical pulsed-field gel electrophoresis profiles. All patients with B. stabilis bacteraemia had indwelling intravenous catheters, which were treated with chlorhexidine to disinfect the catheters. Following identification of the source of contamination, strict controls regarding surveillance cultures for disinfectants have been enforced. No further B. stabilis infections have been found in the hospital.