Department of Microbiology and Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi 110029, India.
Int J Infect Dis. 2019 Feb;79:4-11. doi: 10.1016/j.ijid.2018.10.008. Epub 2018 Oct 17.
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.
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.
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.
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.
描述 1 级创伤中心神经外伤重症监护病房发生的洋葱伯克霍尔德菌暴发的详细流行病学和分子特征。强调了为成功遏制此次暴发而采取的严格感染控制干预措施。
对那些有超过一次血培养出洋葱伯克霍尔德菌的患者的临床和微生物学数据进行了回顾。使用自动 Vitek 2 系统进行细菌鉴定和药敏试验。进行了前瞻性监测、环境采样和多位点序列分型（MLST），以进行广泛的源追踪。采取了强化感染控制措施以进一步控制医院传播。
在总共 48 例洋葱伯克霍尔德菌菌血症患者中，有 15 例（31%）存在中心静脉相关血流感染。共采集了 231 份环境样本进行筛查，只有 2 份水样中生长出具有相似表型特征的洋葱伯克霍尔德菌。通过 MLST 分型特征化的临床菌株是克隆的。然而，来自水的分离株代表了一种新型菌株类型（ST-1289）。进行了强化终末清洁、供水消毒和加强感染控制活动，以遏制暴发。随后观察到菌血症病例减少。
需要早期诊断和适当的治疗，并严格执行必要的医院感染控制措施，才能成功控制这种病原体并遏制此类暴发。
