Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-03T01:27:17.029Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiologic Investigation of Burkholderia cepacia Acquisition in Two Pediatric Intensive Care Units

Published online by Cambridge University Press:  02 January 2015

Chawki Loukil ,
Carole Saizou ,
Catherine Doit ,
Philippe Bidet ,
Patricia Mariani-Kurkdjian ,
Yannick Aujard ,
François Beaufils  and
Edouard Bingen
Chawki Loukil
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Carole Saizou
Affiliation:
Department of Pediatric Intensive Care, Hôpital Robert Debré, Paris, France
Catherine Doit
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Philippe Bidet
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Patricia Mariani-Kurkdjian
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Yannick Aujard
Affiliation:
Department of Neonatology, Hôpital Robert Debré, Paris, France
François Beaufils
Affiliation:
Department of Pediatric Intensive Care, Hôpital Robert Debré, Paris, France
Edouard Bingen*
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
*
Department of Microbiology, Hôpital Robert Debré, 48, Boulevard Serurier, 75019 Paris, France
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To investigate and describe an outbreak of Burkholderia cepacia in a neonatal intensive care unit (NICU) and a pediatric intensive care unit (PICU), and to report the interventions leading to the cessation of the outbreak.

Design:

We conducted an epidemiologic investigation of an outbreak of B. cepacia colonization or infection in two clinical wards during a 35-month period (December 1998 to October 2001).

Setting:

A 500-bed, university hospital-affiliated, tertiary-care pediatric institution in Paris, France, with a 22-bed PICU and 31-bed NICU.

Methods:

Ribotyping was used to determine the genotypes of B. cepacia isolates. Procedures for the maintenance and disinfection of respiratory therapy devices were reviewed.

Results:

Thirty-two children were colonized (n = 14) or infected (n = 18) by B. cepacia in 2 wards (28 in the PICU and 4 in the NICU). In the PICU, a single ribotype was found among the isolates obtained from all of the patients except 1, and from the 6 isolates obtained from respiratory therapy devices (ie, heated humidifier water). In the NICU, the isolates obtained from the patients harbored a single ribotype unrelated to that of the epidemic strain isolated in the PICU; no environmental source of infection was found.

Conclusion:

Two different outbreaks appeared to be associated with 2 ribotypes, 1 of which was linked to patient-to-patient transmission via respiratory therapy devices. Complete elimination of the outbreak was achieved only when disposable, sterilizable, or easy-to-disinfect materials were used in the PICU. The source of infection in the NICU was not found.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 9 , September 2003 , pp. 707 - 710
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Isles, A, Maclusky, I, Corey, M, et al.Pseudomonas cepacia infection in cystic fibrosis: an emerging problem. J Pediatr 1984;104:206–210.Google Scholar
2.Craven, DE, Steger, KA. Nosocomial pneumonia in the intubated patient: new concepts on pathogenesis and prevention. Infect Dis Clin North Am 1989;3:843–866.Google Scholar
3.Marione, WJ, Tablan, OC, Jarvis, WR. Epidemiology of nosocomial epidemic Pseudomonas cepacia infections. Eur J Epidemiol 1987;3:222–232.Google Scholar
4.Mitchell, RG, Hayward, AC. Post-operative urinary tract infections caused by contaminated irrigating fluid. Lancet 1966;1:793–795.Google Scholar
5.Pegues, CF, Pegues, DA, Ford, DS, et al.Burkholderia cepacia respiratory tract acquisition: epidemiology and molecular characterization of a large nosocomial outbreak. Epidemiol Infect 1996;116:309–317.Google Scholar
6.Richard, JH, Houston, ED, Georghiou, PR, et al.An outbreak of Burkholderia (formerly Pseudomonas) cepacia respiratory tract colonization and infection associated with nebulized albuterol therapy. Ann Intern Med 1995;122:762–766.Google Scholar
7.Siddiqui, AW, Mulligan, ME, Mahenthi-Ralingam, E, et al.An episodic outbreak of genetically related Burkholderia cepacia among non-cystic fibrosis patients at a university hospital. Infect Control Hosp Epidemiol 2001;22:419–422.Google Scholar
8.Weems, JJ Jr. Nosocomial outbreak of Pseudomonas cepacia associated with contamination of reusable electronic ventilator temperature probes. Infect Control Hosp Epidemiol 1990;14:583–583.Google Scholar
9.Centers for Disease Control and Prevention. Nosocomial Burkholderia cepacia infection and colonization associated with intrinsically contaminated mouthwash: Arizona, 1998. MMWR 1998;47:926–928.Google Scholar
10.Van Laer, F, Raes, D, Vandamme, P, et al.An outbreak of Burkholderia cepacia with septicemia on a cardiology ward. Infect Control Hosp Epidemiol 1998;19:112–113.Google Scholar
11.Pittet, D. Nosocomial bloodstream infections. In: Wenzel, RP, ed. Prevention and Control of Nosocomial Infections, 2nd ed. Baltimore: Williams & Wilkins; 1993:531–552.Google Scholar
12.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests, 5th ed. Wayne, PANational Committee for Clinical Laboratory Standards; 1993. Approved standard M2-A5.Google Scholar
13.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically, 4th ed. Wayne, PANational Committee for Clinical Laboratory Standards; 1998. Approved standard M7-A4.Google Scholar
14.Bingen, E, Denamur, E, Lambert-Zechovsky, N, et al.DNA restriction fragment length polymorphism differentiates crossed from independent infections in nosocomial Xanthomonas maltophilia bacteremia. J Clin Microbiol 1991;29:1348–1350.Google Scholar
15.Bingen, E, Denamur, E, Lambert-Zechovsky, N, et al.Analysis of DNA restriction fragment length polymorphism extends the evidence for breast milk transmission in Streptococcus agalactiae late-onset neonatal infection. J Infect Dis 1992;165:569–573.Google Scholar
16.Rabkin, CS, Jarvis, WR, Anderson, RL, et al.Pseudomonas cepacia typing systems: collaborative study to assess their potential in epidemiologic investigations. Rev Infect Dis 1989;11:600–607.Google Scholar
17.Holmes, ANolan, R, Taylor, R, et al.Epidemic of Burkholderia cepacia transmitted between patients with and without cystic fibrosis. J Infect Dis 1999;179:1197–1205.Google Scholar
18.Ouchi, K, Abe, M, Karita, M, Oguri, T, Igari, J, Nakazawa, T. Analysis of strains of Burkholderia (Pseudomonas) cepacia isolated in a nosocomial outbreak by biochemical and genomic typing. J Clin Microbiol 1995;33:2353–2357.Google Scholar
19.Bingen, E, Weber, M, Derelle, J, et al.Arbitrarily primed polymerase chain reaction as a rapid method to differentiate crossed from independent Pseudomonas cepacia infections in cystic fibrosis patients. J Clin Microbiol 1993;31:2589–2593.Google Scholar