Jennifer Bender, Sebastian Haller, Yvonne Pfeifer, Michael Hogardt, Klaus-Peter Hunfeld, Andrea Thürmer, Arina Zanuzdana, Markus Werner, Bernd Kunz, David Eisenberger, Niels Ernst Pfennigwerth, Volkhard A. J. Kempf, Guido Werner, Tim Eckmanns
- Background: In September 2018, Burkholderia cepacia complex (BCC) infections in 3 patients associated with exposure to a mouthwash solution (MWS) were reported to the Robert Koch Institute (RKI). As the product was still on the market and the scale of the outbreak was unclear, a nation-wide investigation was initiated.
Methods: We aimed to investigate BCC infections/colonizations associated with MWS. Hospitals, laboratories, and public health services were informed that BCC isolates should be sent to the RKI. These isolates were typed by pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) including development of an ad hoc core genome MLST (cgMLST) scheme.
Results: In total, 36 patients from 6 hospitals met the case definition, the last patient in November 2018. Twenty-nine isolates from 26 of these patients were available for typing. WGS analysis revealed 2 distinct cgMLST clusters. Cluster 1 (Burkholderia arboris) contained isolates from patients and MWS obtained from 4 hospitals and isolates provided by the manufacturer. Patient and MWS isolates from another hospital were assigned to cluster 2 (B. cepacia).
Conclusions: The combined clinical, epidemiological, and microbiological investigation, including whole-genome analysis, allowed for uncovering a supraregional BCC outbreak in health care settings. Strains of B. arboris and B. cepacia were identified as contaminating species of MWS bottles and subsequent colonization and putative infection of patients in several hospitals. Despite a recall of the product by the manufacturer in August 2018, the outbreak lasted until December 2018. Reporting of contaminated medical products and recalls should be optimized to protect patients.
MetadatenAuthor: | Jennifer BenderORCiDGND, Sebastian HallerORCiDGND, Yvonne PfeiferORCiDGND, Michael HogardtORCiDGND, Klaus-Peter HunfeldORCiD, Andrea ThürmerGND, Arina ZanuzdanaGND, Markus WernerGND, Bernd Kunz, David Eisenberger, Niels Ernst PfennigwerthORCiDGND, Volkhard A. J. KempfORCiDGND, Guido WernerORCiDGND, Tim EckmannsGND |
---|
URN: | urn:nbn:de:hebis:30:3-844221 |
---|
DOI: | https://doi.org/10.1093/ofid/ofac114 |
---|
ISSN: | 2328-8957 |
---|
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/35434175 |
---|
Parent Title (English): | Open Forum Infectious Diseases |
---|
Publisher: | Oxford University Press |
---|
Place of publication: | Oxford |
---|
Document Type: | Article |
---|
Language: | English |
---|
Date of Publication (online): | 2022/03/09 |
---|
Date of first Publication: | 2022/03/09 |
---|
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
---|
Release Date: | 2024/05/27 |
---|
Tag: | Burkholderia arboris; burkholderia; burkholderia cepacia complex infections; clonal transfer; disease outbreaks; electrophoresis; familial amyloid nephropathy with urticaria and deafness; gel; genome; infections; medical device; microbial colonization; mouthwash; mouthwash solution; outbreak; pulsed-field |
---|
Volume: | 9 |
---|
Issue: | 5, art. ofac114 |
---|
Article Number: | ofac114 |
---|
Page Number: | 9 |
---|
First Page: | 1 |
---|
Last Page: | 9 |
---|
Note: | Supplementary materials are available at Open Forum Infectious Diseases online. Consisting of data provided by the author that are published to benefit the reader. The posted materials are not copyedited. The contents of all supplementary data are the sole responsibility of the authors. Questions or messages regarding errors should be addressed to the author. |
---|
Note: | This work was supported by funds from the German Federal Ministry of Health to the National Consiliary Laboratory. |
---|
HeBIS-PPN: | 520342879 |
---|
Institutes: | Medizin |
---|
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
---|
Sammlungen: | Universitätspublikationen |
---|
Licence (German): | Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International |
---|