Thu, Jul 16, 2026
1- Department of Microbiology, LLRM Medical College, Meerut, Up, India
2- Department of Pathology, Subharti Medical College, Meerut, Up, India
3- Department of Microbiology, LLRM Medical College, Meerut, Up, India ,naila.1668@gmail.com
2- Department of Pathology, Subharti Medical College, Meerut, Up, India
3- Department of Microbiology, LLRM Medical College, Meerut, Up, India ,
Abstract: (2884 Views)
Background: Burkholderia gladioli (B. gladioli) is a rare but emerging pathogen associated with neonatal sepsis. This case series describes the investigation and control of an outbreak in a tertiary neonatal intensive care unit (NICU) in India.
Methods: In January 2024, seven neonates admitted to the NICU developed bloodstream infections. Clinical manifestations included respiratory distress, feeding refusal, metabolic acidosis, seizures, and shock. Predisposing factors included prematurity, congenital anomalies, and perinatal asphyxia. Blood cultures were processed using the automated BD BactecFX-40 system, and organism identification with antimicrobial susceptibility testing was performed using the BD Phoenix M-50 system. Environmental sampling was conducted to identify the outbreak source.
Results: Of 72 blood culture bottles, 34 (47.2%) flagged positive. B. gladioli were isolated from seven patients, accounting for 20.6% of positive cultures. The overall mortality rate was 57.1% (4/7 Deaths). All clinical isolates showed identical susceptibility patterns, with susceptibility to levofloxacin, cotrimoxazole, ceftazidime, chloramphenicol, minocycline, and meropenem, and intrinsic resistance to colistin. Environmental surveillance identified the same B. gladioli strain from suction apparatus and phototherapy units. Contributory factors included poor hand hygiene compliance (28-33%), limited glove availability, and overcrowding. Following cohorting, deep cleaning with 1% hypochlorite, staff retraining, and reinforcement of infection control protocols, no further isolates were recovered.
Conclusion: This outbreak highlights the high mortality associated with B. gladioli sepsis in neonates and underscores the critical need for stringent infection control practices and automated identification systems in NICUs. To our knowledge, this is the first such report from India.
Methods: In January 2024, seven neonates admitted to the NICU developed bloodstream infections. Clinical manifestations included respiratory distress, feeding refusal, metabolic acidosis, seizures, and shock. Predisposing factors included prematurity, congenital anomalies, and perinatal asphyxia. Blood cultures were processed using the automated BD BactecFX-40 system, and organism identification with antimicrobial susceptibility testing was performed using the BD Phoenix M-50 system. Environmental sampling was conducted to identify the outbreak source.
Results: Of 72 blood culture bottles, 34 (47.2%) flagged positive. B. gladioli were isolated from seven patients, accounting for 20.6% of positive cultures. The overall mortality rate was 57.1% (4/7 Deaths). All clinical isolates showed identical susceptibility patterns, with susceptibility to levofloxacin, cotrimoxazole, ceftazidime, chloramphenicol, minocycline, and meropenem, and intrinsic resistance to colistin. Environmental surveillance identified the same B. gladioli strain from suction apparatus and phototherapy units. Contributory factors included poor hand hygiene compliance (28-33%), limited glove availability, and overcrowding. Following cohorting, deep cleaning with 1% hypochlorite, staff retraining, and reinforcement of infection control protocols, no further isolates were recovered.
Conclusion: This outbreak highlights the high mortality associated with B. gladioli sepsis in neonates and underscores the critical need for stringent infection control practices and automated identification systems in NICUs. To our knowledge, this is the first such report from India.
Keywords: Burkholderia gladioli, Pseudomonas marginata, Disease Outbreaks, Septicemia, Neonatal Intensive Care Unit, Antimicrobial Susceptibility Pattern
Research Article: Research Article |
Subject:
bacteriology
Received: 2024/04/25 | Accepted: 2026/06/6
Received: 2024/04/25 | Accepted: 2026/06/6
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