Neha Rastogi1, Surbhi Khurana2, Balaji Veeraraghavan3, Francis Yesurajan Inbanathan4, Suresh Kumar Rajamani Sekar5, Deepak Gupta6, Keshav Goyal7, Ashish Bindra8, Navdeep Sokhal9, Ashutosh Panda10, Rajesh Malhotra11, Purva Mathur12. 1. Department of Microbiology and Medicine, All India Institute of Medical Sciences, New Delhi, India. Electronic address: neha.rstg@gmail.com. 2. Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: surbhikhurana.11@gmail.com. 3. Department of Clinical Microbiology, CMC, Vellore, India. Electronic address: vbalaji@cmcvellore.ac.in. 4. Department of Clinical Microbiology, CMC, Vellore, India. Electronic address: francisyesurajansci@gmail.com. 5. Department of Clinical Microbiology, CMC, Vellore, India. Electronic address: suresh874u@gmail.com. 6. Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India. Electronic address: drdeepakgupta@gmail.com. 7. Department of Neuroanaesthesiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India. Electronic address: keshavgoyal@yahoo.co.in. 8. Department of Neuroanaesthesiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India. Electronic address: dr_ashi2208@yahoo.com. 9. Department of Neuroanaesthesiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India. Electronic address: drnavdeep_kumar@yahoo.com. 10. Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: ashutoshpanda2086@gmail.com. 11. Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India. Electronic address: rmalhotra62@hotmail.com. 12. Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: purvamathur@yahoo.co.in.
Abstract
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.
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.
Authors: Jennifer K Bender; Sebastian Haller; Yvonne Pfeifer; Michael Hogardt; Klaus-Peter Hunfeld; Andrea Thürmer; Arina Zanuzdana; Markus Werner; Bernd Kunz; David Eisenberger; Niels Pfennigwerth; Volkhard A J Kempf; Guido Werner; Tim Eckmanns Journal: Open Forum Infect Dis Date: 2022-03-09 Impact factor: 3.835