[An outbreak of Burkholderia cepacia bacteremia in a hemodialysis unit, Cadiz, 2014]

Enferm Infecc Microbiol Clin. 2015 Dec;33(10):646-50. doi: 10.1016/j.eimc.2015.02.013. Epub 2015 Mar 29.
[Article in Spanish]

Abstract

Introduction: In January 2014 a possible outbreak of Burkholderia cepacia bacteremia occurred in a hemodialysis center situated in La Linea de la Concepción (Cadiz). An investigation was begun to confirm the outbreak, identify the source, and implement control measures.

Methods: A descriptive analysis was performed to describe the characteristics of the patients affected with Burkholderia cepacia bacteremia from November 2013 to February 2014. Environmental samples were taken. A molecular typing study was performed using pulsed field gel electrophoresis (SpeI PFGE) and MLST analysis in order to determine the genetic similarity between the isolates.

Results: The bacterium was isolated from blood cultures of 7 patients during the study period. Three of the samples (2 of which were also cases) were endoluminal fluid from catheter locks, and 4 chlorhexidine bottle samples. The patients were coincident in 2 of the 6 work shifts. The mean age of the cases was 67 years of whom 57% were women. Human samples and an environmental sample was analyzed and found to be genetically identical (ST653 clone).

Conclusions: The analysis confirmed the outbreak of Burkholderia cepacia, with 7 cases among the patients of the hemodialysis center. The outbreak was due to the same strain, probably a common source and secondary transmission from person to person.

Keywords: Bacteremia; Bacteriemia; Brotes de enfermedades; Burkholderia cepacia; Cross infection; Disease outbreaks; Diálisis renal; Infección hospitalaria; Renal dialysis.

MeSH terms

  • Aged
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Bacterial Typing Techniques
  • Burkholderia Infections / epidemiology*
  • Burkholderia Infections / microbiology
  • Burkholderia Infections / prevention & control
  • Burkholderia Infections / transmission
  • Burkholderia cepacia / classification
  • Burkholderia cepacia / genetics
  • Burkholderia cepacia / isolation & purification*
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Cross Infection / transmission
  • DNA, Bacterial / analysis
  • Disease Outbreaks*
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Hospital Units*
  • Hospitals, Urban
  • Humans
  • Male
  • Middle Aged
  • Multilocus Sequence Typing
  • Renal Dialysis*
  • Risk Factors
  • Spain / epidemiology

Substances

  • DNA, Bacterial