重症监护病房中由受污染沐浴液引发的洋葱伯克霍尔德菌感染暴发：控制措施及微生物学调查结果

A Burkholderia contaminans outbreak in an intensive care unit associated with contaminated bath solution: Control and microbiological findings.

作者信息

de Sá Paraskevopoulos Daniela Kallíope, Camargo Carlos Henrique, Kodato Priscila Koba, Yamada Amanda Yaeko, Almodovar Adriana Aparecida Buzzo, Hilinski Ellen Gameiro, de Paula Alexandre Inácio, Irineu Elaine Fernanda, Barrio Sandra Rodrigues, Fonseca Cibele L, de Melo Gamba Cristiano, Hosino Nair, Yamaguti Augusto, de Mendonça João S, Guimarães Thaís

机构信息

Infection Control Department, Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil.

Bacteriology Division, Adolfo Lutz Institute, São Paulo, Brazil.

出版信息

Am J Infect Control. 2025 Mar;53(3):308-313. doi: 10.1016/j.ajic.2024.10.006. Epub 2024 Oct 22.

DOI:10.1016/j.ajic.2024.10.006

PMID:39447645

Abstract

BACKGROUND

The Burkholderia cepacia complex comprises a group of bacteria with a growing threat as a contaminant of nonsterile solutions. We describe an outbreak of a Burkholderia cepacia complex involving patients at intensive care unit related to a no-rinse bathing solution (NRBS).

METHODS

We carried out patients, environmental and laboratory investigation performing analyses of cases, pulsed-field-gel electrophoresis and whole genome sequence (WGS) of isolates.

RESULTS

We investigated 32 cases and 16 isolates that were identified as Burkholderia contaminans, belonging to 2 different clones. One clone (new ST2175) was identified in 6 sequences (4 from patients and 2 from bath cart samples) and for the remaining 10 isolates (7 isolates from patients and 3 from NRBS) we identified the ST762. The investigation demonstrated that NRBS was the source of the outbreak caused by ST762 clone of B contaminans.

DISCUSSION

Early suspicion of a common source, rapid implementation of control measures, and laboratory support are vital in an outbreak investigation. We also highlight the role of WGS which was very important to conclude our investigation regarding environmental samples and bacterial typing.

CONCLUSIONS

We highlight the need to regulate water-based products and the role of WGS for investigate environmental samples.

摘要

背景

洋葱伯克霍尔德菌复合体是一组细菌，作为非无菌溶液的污染物，其威胁日益增加。我们描述了一起与免冲洗沐浴液（NRBS）相关的重症监护病房患者洋葱伯克霍尔德菌复合体暴发事件。

方法

我们对患者、环境和实验室进行了调查，对病例进行分析，对分离株进行脉冲场凝胶电泳和全基因组测序（WGS）。

结果

我们调查了32例病例和16株被鉴定为污染伯克霍尔德菌的分离株，它们属于2个不同的克隆。在6个序列中鉴定出一个克隆（新的ST2175）（4个来自患者，2个来自浴车样本），对于其余10株分离株（7株来自患者，3株来自NRBS），我们鉴定出ST762。调查表明，NRBS是由污染伯克霍尔德菌ST762克隆引起的暴发源。