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

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.

Keywords: Environment; Healthcare-associated infections; Skincare products; Water quality; Whole genome sequence.