ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Multistate Outbreak of Burkholderia cepacia Complex Bloodstream Infections After Exposure to Contaminated Saline Flush Syringes: United States, 2016-2017.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Burkholderia arboris bacteremia initially identified as Burkholderia cepacia complex: a genome-based case report.Archives of microbiology · 2026Article
- Laboratory strategies for the identification of Burkholderia species: From classical phenotyping to advanced genomic and proteomic approaches.Antonie van Leeuwenhoek · 2026Review
- An outbreak ofInfection control and hospital epidemiology · 2023Article
- Multivalent Fucosides Targeting β-Propeller Lectins from Lung Pathogens with Promising Anti-Adhesive Properties.ACS chemical biology · 2022Article
- Fungal Endophthalmitis Outbreak after Cataract Surgery, South Korea, 2020.Emerging infectious diseases · 2022Article
- Combined Clinical, Epidemiological, and Genome-Based Analysis Identified a Nationwide Outbreak ofOpen forum infectious diseases · 2022Article
- A pseudo-outbreak of Burkholderia cepacia complex in a Kentucky hospital.American journal of infection control · 2022Article
- An intermittent outbreak ofJournal of infection prevention · 2022Article
- Practical Guidance for Clinical Microbiology Laboratories: Diagnosis of Ocular Infections.Clinical microbiology reviews · 2021Review
- Polyclonal Burkholderia cepacia Complex Outbreak in Peritoneal Dialysis Patients Caused by Contaminated Aqueous Chlorhexidine.Emerging infectious diseases · 2020Article
- Review
- Investigation of healthcare infection risks from water-related organisms: Summary of CDC consultations, 2014-2017.Infection control and hospital epidemiology · 2019Observational
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16 authors.
Funding
Abstract
backgroundBurkholderia cepacia complex (Bcc) has caused healthcare-associated outbreaks, often in association with contaminated products. The identification of 4 Bcc bloodstream infections in patients residing at a single skilled nursing facility (SNF) within 1 week led to an epidemiological investigation to identify additional cases and the outbreak source.
methodsA case was initially defined via a blood culture yielding Bcc in a SNF resident receiving intravenous therapy after 1 August 2016. Multistate notifications were issued to identify additional cases. Public health authorities performed site visits at facilities with cases to conduct chart reviews and identify possible sources. Pulsed-field gel electrophoresis (PFGE) was performed on isolates from cases and suspect products. Facilities involved in manufacturing suspect products were inspected to assess possible root causes.
resultsAn outbreak of 162 Bcc bloodstream infections across 59 nursing facilities in 5 states occurred during September 2016-January 2017. Isolates from patients and pre-filled saline flush syringes were closely related by PFGE, identifying contaminated flushes as the outbreak source and prompting a nationwide recall. Inspections of facilities at the saline flush manufacturer identified deficiencies that might have led to the failure to sterilize a specific case containing a partial lot of the product.
conclusionsCommunication and coordination among key stakeholders, including healthcare facilities, public health authorities, and state and federal agencies, led to the rapid identification of an outbreak source and likely prevented many additional infections. Effective processes to ensure the sterilization of injectable products are essential to prevent similar outbreaks in the future.
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