Department of Clinical Microbiology and Hospital Infections, Clinical Hospital Dubrava, Zagreb, Croatia.
Clinical Department of Clinical and Molecular Microbiology and Hospital Infections, University Hospital Center Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia.
Int J Infect Dis. 2022 Aug;121:152-156. doi: 10.1016/j.ijid.2022.05.012. Epub 2022 May 11.
Burkholderia gladioli has been associated with infections in patients with cystic fibrosis, chronic granulomatous disease, and other immunocompromising conditions. The aim of this study was to better depict the outbreak of healthcare-associated bacteremia caused by B. gladioli due to exposure to contaminated multidose vials with saline solutions.
An environmental and epidemiologic investigation was conducted by the Infection Prevention and Control Team (IPCT) to identify the source of the outbreak in three Croatian hospitals.
During a 3-month period, 13 B. gladioli bacteremia episodes were identified in 10 patients in three Croatian hospitals. At the time of the outbreak, all three hospitals used saline products from the same manufacturer. Two 100-ml multidose vials with saline solutions and needleless dispensing pins were positive for B. gladioli. All 13 bacteremia isolates and two isolates from the saline showed the same antimicrobial susceptibility patterns and pulsed-field gel electrophoresis profile, demonstrating clonal relatedness.
When an environmental pathogen causes an outbreak, contamination of intravenous products must be considered. Close communication between the local IPCT and the National Hospital Infection Control Advisory Committee is essential to conduct a prompt and thorough investigation and find the source of the outbreak.
类鼻疽伯克霍尔德菌与囊性纤维化、慢性肉芽肿病和其他免疫功能低下患者的感染有关。本研究旨在更好地描述因接触受污染的多剂量生理盐水小瓶而导致的与医疗保健相关的类鼻疽伯克霍尔德菌菌血症暴发。
感染预防和控制小组（IPCT）进行了环境和流行病学调查，以确定克罗地亚三家医院暴发的源头。
在三个月的时间里，克罗地亚的三家医院共发现了 10 名患者 13 例类鼻疽伯克霍尔德菌菌血症。在暴发期间，三家医院都使用了同一制造商的生理盐水产品。两个 100 毫升的多剂量生理盐水小瓶和无针输液针均为类鼻疽伯克霍尔德菌阳性。所有 13 株菌血症分离株和 2 株来自生理盐水的分离株均表现出相同的抗菌药物敏感性模式和脉冲场凝胶电泳图谱，表明具有克隆相关性。
当环境病原体引起暴发时，必须考虑静脉内产品的污染。当地 IPCT 与国家医院感染控制咨询委员会之间的密切沟通对于进行及时和彻底的调查以及找到暴发的源头至关重要。
