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Burkholderia cepacia pseudobacteremia traced to contaminated antiseptic used for skin antisepsis prior to blood collection

Tandel, Kundan; Bhatt, Puneet; Sen, Sourav; Gupta, Rajiv Mohan; Hazra, Nandita; Praharaj, A.K.; Kumar, Satish; Sahni, A.K.

Reviews in Medical Microbiology: October 2016 - Volume 27 - Issue 4 - p 136–140
doi: 10.1097/MRM.0000000000000082

Background: Burkholderia (previously Pseudomonas) cepacia is a Gram-negative bacillus commonly found in soil and moist environments and capable of surviving and growing in nutrient-poor surroundings. It is a problematic pulmonary pathogen in patients with cystic fibrosis and is associated with a poor prognosis. Small hospital outbreaks are frequent, usually because of a single contaminated source such as disinfectant.

Aim: To identify the source and route of infection of B. cepacia grown from 12 patients from a surgical ICU.

Methods: We carried out an environmental and epidemiological investigation to identify the source and route of infection. Environmental samples previously reported to be potential reservoirs of B. cepacia were collected and processed.

Results: Out of 67 blood samples received in a 2-month period from the ICU (surgical) of a tertiary care centre, B. cepacia was isolated from blood specimens of 12 patients, whereas 34 samples grew organisms other than B. Cepacia, 20 specimens were culture negative. There were no cases of B. Cepacia in the last 1 year before this outbreak. We isolated B. cepacia from the cetrimide + chlorhexidine solution used for skin antisepsis prior to blood collection.

Conclusion: B. cepacia has the potential to cause fatal infections and its multidrug resistance makes its presence dangerous in hospital settings. The surveillance of B. cepacia infections should not be neglected, especially in the ICUs. Given the high transmissibility of the microorganism and previous epidemic reports, strict infection control measures should be applied in the case of diagnosis of B. cepacia infection.

aDRDE, Gwalior, Madhya Pradesh

bCH (SC), Pune, Maharashtra

cDepartment of Microbiology, Army Hospital (Research & Referral), New Delhi

dDepartment of Lab Sciences and Molecular Medicine, Army Hospital (Research & Referral), Delhi Cantt, Delhi

eCommand Hospital (CC), Lucknow

fDepartment of Microbiology, AIIMS, Bhubaneshwar

gDepartment of Microbiology, AFMC, Pune, Maharashtra

hMilitary Hospital, Bhatinda, Punjab, India.

Correspondence to Kundan Tandel, Department of Virology, DRDE Gwalior, MP 474002, India. E-mail:

Received 4 December, 2015

Revised 23 April, 2016

Accepted 25 April, 2016

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