Infection Control Department, Division of Infectious Diseases and Immunology, Gold Coast Hospital and Health Service and Griffith University, Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
Infectious Diseases and Immunology, Gold Coast Hospital and Health Service, Pathology Queensland, Health Support Queensland, Department of Health, Queensland Government, Gold Coast University Hospital, Southport, Queensland, Australia.
Am J Infect Control. 2017 Sep 1;45(9):954-958. doi: 10.1016/j.ajic.2017.06.025. Epub 2017 Jul 27.
We report an outbreak of Burkholderia cenocepacia bacteremia and infection in 11 patients predominately in intensive care units caused by contaminated ultrasound gel used in central line insertion and sterile procedures within 4 hospitals across Australia.
Burkholderia cenocepacia was first identified in the blood culture of a patient from the intensive care unit at the Gold Coast University Hospital on March 26, 2017, with 3 subsequent cases identified by April 7, 2017. The outbreak response team commenced investigative measures.
The outbreak investigation identified the point source as contaminated gel packaged in sachets for use within the sterile ultrasound probe cover. In total, 11 patient isolates of B cenocepacia with the same multilocus sequence type were identified within 4 hospitals across Australia. This typing was the same as identified in the contaminated gel isolate with single nucleotide polymorphism-based typing, demonstrating that all linked isolates clustered together.
Arresting the national point-source outbreak within multiple jurisdictions was critically reliant on a rapid, integrated, and coordinated response and the use of informal professional networks to first identify it. All institutions where the product is used should look back at Burkholderia sp blood culture isolates for speciation to ensure this outbreak is no larger than currently recognized given likely global distribution.
我们报告了一起在澳大利亚 4 家医院内发生的，以重症监护病房为主的 11 例洋葱伯克霍尔德菌菌血症和感染爆发事件，这是由用于中心静脉置管和无菌操作的污染超声凝胶引起的。
2017 年 3 月 26 日，黄金海岸大学医院重症监护病房的一名患者血液培养中首次发现洋葱伯克霍尔德菌，随后在 2017 年 4 月 7 日前又发现了 3 例病例。疫情应对小组开始采取调查措施。
疫情调查确定了污染源为包装在小袋中的污染凝胶，用于无菌超声探头套。在澳大利亚的 4 家医院中，共发现了 11 例患者分离出的洋葱伯克霍尔德菌，具有相同的多位点序列类型。这种分型与污染凝胶分离株的基于单核苷酸多态性的分型相同，表明所有相关的分离株都聚集在一起。
在多个司法管辖区内迅速、综合和协调的应对以及利用非正式的专业网络来首先识别疫情，对于阻止全国性的点状疫情爆发至关重要。所有使用该产品的机构都应该回顾洋葱伯克霍尔德菌血培养分离株的鉴定情况，以确保在全球范围内可能分布的情况下，该疫情的规模不会比目前所认识的更大。
