Back to the articles list | Back to browse issues page

XML Print

OUTBREAK OF BURKHOLDERIA GLADIOLI: AN “ALARMING PERIL” CAUSING SEPTICEMIA IN NEONATAL INTENSIVE CARE UNIT: A RARE STUDY
Karvi Agarwal1 , Naila Begum2 , Konpal Agarwal3
1- assistant professor
2- SENIOR RESIDENT , naila.1668@gmail.com
3- junior resident
Abstract:   (551 Views)
OBJECTIVES:  To investigate the outbreak in the NICU of a tertiary care hospital in western UP in India and to know the source of infection by doing root cause analysis, study the clinical profiles and outcomes of neonates with Burkholderia gladioli septicemia, to determine the antimicrobial susceptibility pattern of these isolates and to take adequate CAPA.
METHODOLOGY: During the month of January 2024, multiple Burkholderia gladioli isolates with similar AST pattern were isolated from blood cultures of babies admitted to NICU of our hospital. An outbreak was suspected with mortality rate of 57.1%. The NICU in-charge and HIC team were alerted to follow up the patients and to investigate this outbreak for CAPA and RCA. Environmental Surveillance was done for NICU. Burkholderia gladioli was successfully isolated from suction apparatus and phototherapy units as confirmed by Automated BD Phoenix System.
RESULTS: Out of 72, 34 bottles signaled/flagged positive for microbial growth, with positivity rate of 47.2%. Among the positive cultures, Burkholderia gladioli were isolated from seven different patients, contributing to major percentage of 20.6% of total positivity. The Identification and Antimicrobial susceptibility testing were performed by Automated BD Phoenix system
CONCLUSION: This outbreak investigation raises the concern regarding the potential severity of Burkholderia gladioli septicemia in NICU set up and the need to broaden clinicians' suspicion for this rare bug. Rapid identification of the outbreak, defining the source and taking appropriate infection control measures to control the outbreak are the key points in managing and improving the neonatal outcome.
 
Keywords: Burkholderia gladioli Outbreak, Septicemia, NICU (neonatal intensive care unit), Hospital infection control (HIC), CAPA (corrective Action Preventive Action), RCA (Root cause analysis), Environmental Surveillance
Full-Text [PDF 401 kb]   (168 Downloads)    
Research Article: Research Article | Subject: bacteriology
Received: 2024/04/25 | Accepted: 2026/06/6
References
1. Dursun, A, Zenciroglu A, Karagol, BS, Hakan N, Okumus N, Gol N, et al. Burkholderia gladioli sepsis in newborns. Eur J Pediatr. 2012;171(10):1503-9 [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Procop GW. The non-fermentative gram-negative bacilli. In: Procop GW, Church DL, Hall GS, Janda WM, Koneman EW, Schreckenberger, Paul C, et al. editors. Koneman's color atlas and textbook of diagnostic microbiology. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2017. p. 317-431. [View at Publisher] [Google Scholar]
3. Zhou F, Ning H, Chen F, Wu W, Chen A, Zhang J. Burkholderia gladioli infection isolated from the blood cultures of newborns in the neonatal intensive care unit. Eur J Clin Microbiol Infect Dis. 2015;34(8):1533-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Murray TS, Baltimore RS. Pseudomonas, Burkholderia, and Stenotrophomonas. In: Robert M. Kliegman, Joseph St. Geme, editors. Nelson textbook of pediatrics. 21th edition. Philadelphia: Elsevier Inc; 2019, p. 1529-33 [View at Publisher]
5. Graves M, Robin T, Chipman AM, Wong J, Khashe S, Janda JM. Four additional cases of B. gladioli infection with microbiological correlates and review. Clin Infect Dis. 1997;25(4):838-42. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Bedir Demirdag T, Ozkaya Parlakay A, Aygar IS, Gulhan B, Kanik Yuksek S. Major Aspects of B. gladioli and Burkholderia cepacia Infections in Children. Pediatr Infect Dis J. 2020;39(5):374-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, editors Manual of Clinical Microbiology. 9th ed. Washington (DC): ASM Press; 2007. [View at Publisher]
8. Sastry AS, Deepashree R. Disinfection policy. In: Sastry AS, Deepashree R, editors. Essentials of Hospital Infection Control. 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2019. p. 269-71. [View at Publisher] [Google Scholar]
9. Hoare S, Cant AJ. Chronic granulomatous disease presenting as severe sepsis due to Burkholderia gladioli. Clin Infect Dis.1996;23(2):411. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Shin JH, Kim SH, Shin MG, Suh SP, Ryang DW, Jeong MH. Bacteremia due to Burkholderia gladioli: case report. Clin Infect Dis. 1997;25(5):1264-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Boyanton BL Jr, Noroski LM, Reddy H, Dishop MK, Hicks MJ, Versalovic J et al. Burkholderia gladioli osteomyelitis in association with chronic granulomatous disease: case report and review. Pediatr Infect Dis J. 2005;24(9):837-9 [View at Publisher] [DOI] [PMID] [Google Scholar]
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.