Wed, Aug 27, 2025
1- Department of Microbiology, Goverment Medical College and Hospital (GMCH), Nagpur, Maharashtra, India , drshayosree.sarkar@gmail.com
2- Department of Microbiology, Goverment Medical College and Hospital (GMCH), Nagpur, Maharashtra, India
2- Department of Microbiology, Goverment Medical College and Hospital (GMCH), Nagpur, Maharashtra, India
Abstract: (639 Views)
Background: Burkholderia cepacia complex (BCC) is an opportunistic nosocomial pathogen known to cause severe infections in neonates, including those affecting the respiratory and urinary tracts, as well as bloodstream infections. Consequently, BCC has the potential to instigate outbreaks originating from various sources. This study was undertaken to facilitate the early detection and effective control of a BCC-related outbreak.
Methods: A cross-sectional study, conducted in July 2023 at a tertiary care hospital, investigated bacterial isolates from neonates. Over a one-month period, eleven neonates' blood cultures grew motile, oxidase-positive, non-fermenting gram-negative bacilli. These isolates were presumptively identified as BCC based on conventional biochemical tests and their antimicrobial susceptibility profiles. The recurring isolation of an identical bacterial strain within the neonatal intensive care unit (NICU) strongly suggested an ongoing outbreak. Consequently, active surveillance was initiated to identify the source of the infection and implement containment measures. The identity of the isolated strains was subsequently confirmed using the VITEK 2 Compact microbiology analyser (BioMérieux, France).
Results: Surveillance identified the BCC sources for all 11 affected neonates. The investigation traced the infection origins to several environmental factors within the healthcare setting, including intravenous (IV) catheters and neonatal cradles, operating theatre (OT) beds, and instrument trolleys in the labour room where the deliveries occurred. Furthermore, all environmental BCC isolates demonstrated genetic relatedness to the clinical isolates concurrently exhibiting a similar antibiotic susceptibility pattern. Timely interventions were instrumental in controlling the outbreak.
Conclusion: This study highlights the critical role of the hospital infection control team in effectively managing a BCC outbreak among neonates.
Methods: A cross-sectional study, conducted in July 2023 at a tertiary care hospital, investigated bacterial isolates from neonates. Over a one-month period, eleven neonates' blood cultures grew motile, oxidase-positive, non-fermenting gram-negative bacilli. These isolates were presumptively identified as BCC based on conventional biochemical tests and their antimicrobial susceptibility profiles. The recurring isolation of an identical bacterial strain within the neonatal intensive care unit (NICU) strongly suggested an ongoing outbreak. Consequently, active surveillance was initiated to identify the source of the infection and implement containment measures. The identity of the isolated strains was subsequently confirmed using the VITEK 2 Compact microbiology analyser (BioMérieux, France).
Results: Surveillance identified the BCC sources for all 11 affected neonates. The investigation traced the infection origins to several environmental factors within the healthcare setting, including intravenous (IV) catheters and neonatal cradles, operating theatre (OT) beds, and instrument trolleys in the labour room where the deliveries occurred. Furthermore, all environmental BCC isolates demonstrated genetic relatedness to the clinical isolates concurrently exhibiting a similar antibiotic susceptibility pattern. Timely interventions were instrumental in controlling the outbreak.
Conclusion: This study highlights the critical role of the hospital infection control team in effectively managing a BCC outbreak among neonates.
References
1. Depoorter E, Bull MJ, Peeters C, Coenye T, Vandamme P, Mahenthiralingam E. Burkholderia: an update on taxonomy and biotechnological potential as antibiotic producers. Appl Microbiol Biotechnol. 2016;100(12):5215-29. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Safdar A. Stenotrophomonas maltophilia and Burkholderia cepacia. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Elsevier. 2015;2532-2540.e4. [View at Publisher] [DOI]
3. Sutton S. What is an objectionable organism. Am Pharmaceut Rev. 2012;15(6):36-48. [View at Publisher]
4. Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired neonatal infections in developing countries. Lancet. 2005;365(9465):1175-88 [View at Publisher] [DOI] [PMID] [Google Scholar]
5. Collee JG, Marr W. Culture containers and culture media. Mackie and McCartney Practical Microbiology. 14th ed., Ch. 6. New York: Churchill Livingstone; 1996;131-49. [View at Publisher]
6. Mackie TJ. Mackie and McCartney practical medical microbiology 14th edition. New York: Churchill Livingstone. 2006. [View at Publisher]
7. Procop GW, Church DL, Hall GS, Janda WM,Koneman EW,Schreckenberger PC, et al. Koneman's color atlas and textbook of diagnostic microbiology. Jones & Bartlett Learning; 2020:1. [View at Publisher] [Google Scholar]
8. Clinical and Laboratory Standards Institute (CLSI) document M100-Ed33. Performance standards for antimicrobial susceptibility testing. 33rd Inf Suppl. 2023;39(1):50-2. [View at Publisher]
9. Doit C, Loukil C, Simon AM, Ferroni A, Fontan JE, Bonacorsi S, et al. Outbreak of Burkholderia cepacia Bacteremia in a Pediatric Hospital Due to Contamination of Lipid Emulsion Stoppers. J Clin Microbiol. 2004;42(5):2227-30. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Nasser RM, Rahi AC, Haddad MF, Daoud Z, Irani-Hakime N, Almawi WY. Outbreak of Burkholderia Cepacia Bacteremia Traced to Contaminated Hospital Water Used for Dilution of an Alcohol Skin Antiseptic. Infect Control Hosp Epidemiol. 2004;25(3):231-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Belachew A, Tewabe T. Neonatal sepsis and its association with birth weight and gestational age among admitted neonates in Ethiopia: systematic review and meta-analysis. BMC Pediatrics. 2020;20(1):55. [View at Publisher] [DOI] [PMID] [Google Scholar]
12. Murthy S, Godinho MA, Guddattu V, Lewis LES, Nair NS. Risk factors of neonatal sepsis in India: A systematic review and meta-analysis. PloS One. 2019;14(4):e0215683. [View at Publisher] [DOI] [PMID] [Google Scholar]
13. Patra S, Bhat Y R, Lewis LE, Purakayastha J, Sivaramaraju VV, Kalwaje E V, et al. Burkholderia cepacia sepsis among neonates. Indian J Pediatr. 2014;81(11):1233-6. [View at Publisher] [DOI] [PMID] [Google Scholar]
14. El Chakhtoura NG, Saade E, Wilson BM, Perez F, Papp-Wallace KM, Bonomo RA. A 17-Year Nationwide Study of Burkholderia cepacia Complex Bloodstream Infections Among Patients in the United States Veterans Health Administration.Clin Infect Dis. 2017;65(8):1253-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
15. Pataskar A, Chandel A, Chauhan V, Jain M. Gram-negative Late Onset Neonatal Sepsis in a Tertiary Care Center From Central India: A Retrospective Analysis. Clin Med Insights Pediatr. 2023;17:11795565231189595. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Torbeck L, Raccasi D, Guilfoyle DE, Friedman RL, Hussong D. Burkholderia cepacia: This Decision Is Overdue. PDA J Pharm Sci Technol. 2011;65(5):535-43. [View at Publisher] [DOI] [PMID] [Google Scholar]
17. Bharara T, Chakravarti A, Sharma M, Agarwal P. Investigation of Burkholderia cepacia complex bacteremia outbreak in a neonatal intensive care unit: a case series. J Med Case Reports. 2020;14(1):76. [View at Publisher] [DOI] [PMID] [Google Scholar]
18. Bhise SM, Rahangdale VA, Qazi MS. Burkholderia Cepacia an emerging cause of septicemia-an outbreak in a neonatal Intensive Care Unit from a tertiary care hospital of central India. IOSR J Dent Med Sci. 2013;10:41-3. [View at Publisher] [DOI] [Google Scholar]
19. Mali S, Dash L, Gautam V, Shastri J, Kumar S. An Outbreak of Burkholderia cepacia Complex in the Paediatric Unit of a Tertiary Care Hospital. Indian J Med Microbiol. 2017;35(2):216-20. [View at Publisher] [DOI] [PMID] [Google Scholar]
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