Jacobson Michelle, Wray Rick, Kovach Danuta, Henry Deborah, Speert David, Matlow Anne
Hospital for Sick Children, Toronto, Ontario, Canada.
Infect Control Hosp Epidemiol. 2006 Apr;27(4):362-6. doi: 10.1086/503343. Epub 2006 Mar 17.
To determine whether contaminated ultrasound gel is the source of intermittent outbreaks of nosocomial infection due to Burkholderia cepacia complex in patients without cystic fibrosis since 1992.
A prospective clinical and in vitro study of all in-use bottles of ultrasound gel, as well as a retrospective analysis of archived bacterial strains, were performed. Handling of gel for clinical purposes throughout the hospital was evaluated. Gel and archived clinical isolates of B. cepacia complex were speciated to genomovar level and characterized by pulsed-field gel electrophoresis, and the pulsed-field gel electrophoresis patterns were compared.
The Hospital for Sick Children, a 300-bed, tertiary care, pediatric academic health sciences center in Toronto, Canada.
All patients without cystic fibrosis from whom B. cepacia complex was recovered at the Hospital for Sick Children since 1992.
No standardized protocol for storage or handling of ultrasound gel was found. Gel from 39% of bottles grew either B. cepacia (genomovar I) or Burkholderia stabilis (genomovar IV). These isolates had pulsed-field gel electrophoresis patterns identical to 2 of the 7 clinical pulsed-field gel electrophoresis types that are responsible for 88% of clinical isolates.
Contaminated ultrasound gel contributed to nosocomial infection due to B. cepacia complex in this institution over the course of 10 years. Suggested guidelines for the handling of ultrasound gel are provided.
确定自1992年以来，受污染的超声凝胶是否为非囊性纤维化患者中洋葱伯克霍尔德菌复合体所致医院感染间歇性暴发的源头。
对所有在用的超声凝胶瓶进行前瞻性临床和体外研究，并对存档的细菌菌株进行回顾性分析。评估了整个医院临床使用凝胶的处理情况。将凝胶和洋葱伯克霍尔德菌复合体的存档临床分离株鉴定到基因变种水平，并通过脉冲场凝胶电泳进行特征分析，比较脉冲场凝胶电泳图谱。
加拿大多伦多一家拥有300张床位的三级护理儿科学术健康科学中心——病童医院。
自1992年以来在病童医院分离出洋葱伯克霍尔德菌复合体的所有非囊性纤维化患者。
未发现超声凝胶储存或处理的标准化方案。39%的凝胶瓶中的凝胶培养出洋葱伯克霍尔德菌（基因变种I）或稳定伯克霍尔德菌（基因变种IV）。这些分离株的脉冲场凝胶电泳图谱与导致88%临床分离株的7种临床脉冲场凝胶电泳类型中的2种相同。
在10年期间，受污染的超声凝胶导致了该机构内由洋葱伯克霍尔德菌复合体引起的医院感染。提供了超声凝胶处理的建议指南。
