Alvarez-Lerma Francisco, Maull Elena, Terradas Roser, Segura Concepción, Planells Irene, Coll Pere, Knobel Hernando, Vázquez Antonia
Service of Intensive Care Medicine, Hospital Universitari del Mar, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, E-08003 Barcelona, Spain.
Crit Care. 2008;12(1):R10. doi: 10.1186/cc6778. Epub 2008 Jan 31.
An outbreak of severe nosocomial Burkholderia cepacia infections in patients admitted to intensive care unit (ICU), including investigation of the reservoir, is described.
Over a period of 18 days, isolates of Burkholderia cepacia were recovered from different biological samples from five patients who were admitted to a multidisciplinary 18-bed intensive care unit. Isolation of B. cepacia was associated with bacteraemia in three cases, lower respiratory tract infection in one and urinary tract infection in one. Contact isolation measures were instituted; new samples from the index patients and adjacent patients were collected; and samples of antiseptics, eau de Cologne and moisturizing body milk available in treatment carts at that time were collected and cultured.
B. cepacia was isolated from three samples of the moisturizing body milk that had been applied to the patients. Three new hermetically closed units, from three different batches, were sent for culture; two of these were positive as well. All strains recovered from environmental and biological samples were identified as belonging to the same clone by pulsed-field gel electrophoresis. The cream was withdrawn from all hospitalization units and no new cases of B. cepacia infection developed.
Moisturizing body milk is a potential source of infection. In severely ill patients, the presence of bacteria in cosmetic products, even within accepted limits, may lead to severe life-threatening infections.
描述了在一家重症监护病房（ICU）收治的患者中爆发的严重医院内洋葱伯克霍尔德菌感染事件，包括对感染源的调查。
在18天的时间里，从一家拥有18张床位的多学科重症监护病房收治的5名患者的不同生物样本中分离出洋葱伯克霍尔德菌。分离出洋葱伯克霍尔德菌的情况为3例伴有菌血症，1例为下呼吸道感染，1例为尿路感染。采取了接触隔离措施；采集了索引患者和相邻患者的新样本；并采集了当时治疗推车上可用的防腐剂、古龙水和保湿身体乳样本进行培养。
从涂抹在患者身上的保湿身体乳的3份样本中分离出洋葱伯克霍尔德菌。送检了来自三个不同批次的三个新的密封包装产品进行培养；其中两份也呈阳性。通过脉冲场凝胶电泳鉴定，从环境和生物样本中分离出的所有菌株均属于同一克隆。该身体乳从所有住院病房撤出，此后未再出现新的洋葱伯克霍尔德菌感染病例。
保湿身体乳是一个潜在的感染源。在重症患者中，即使化妆品中的细菌含量在可接受范围内，也可能导致严重的危及生命的感染。
