Polyclonal Burkholderia cepacia Complex Outbreak in Peritoneal Dialysis Patients Caused by Contaminated Aqueous Chlorhexidine

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Wong, Sally C.Y. ; Wong, Shuk-Ching ; Chen, Jonathan H.K. ; Poon, Rosana W.S. ; Hung, Derek L.L. ; Chiu, Kelvin H.Y. ; So, Simon Y.C. ; Leung, Wing Shan ; Chan, Tak Mao ; Yap, Desmond Y.H. ; Chuang, Vivien W.M. ; Yuen, Kwok-Yung ; Cheng, Vincent C.C.
• Description:
  Whether Burkholderia cepacia complex should be an objectionable organism in antiseptic solutions with acceptable total bacterial counts is controversial. By using next-generation sequencing, we documented a polyclonal B. cepacia complex outbreak affecting peritoneal dialysis patients in Hong Kong that was caused by contaminated chlorhexidine solutions. Epidemiologic investigations at a manufacturing site identified a semiautomated packaging machine as the probable source of contamination in some of the brands. Use of whole-genome sequencing differentiated the isolates into 3 brand-specific clonal types. Changes in exit site care recommendations, rapid recall of affected products, and tightening of regulatory control for chlorhexidine-containing skin antiseptics could prevent future similar outbreaks. Environmental opportunistic pathogens, including B. cepacia complex, might be included in regular surveillance as indicator organisms for monitoring environmental contamination.
• Subjects:
  B. Cenocepacia Chlorhexidine Genomic Sequencing Nosocomial Infections Peritoneal Dialysis
• Source:
  Emerg Infect Dis. 26(9):1987-1997
• Pubmed ID:
  32818396
• Pubmed Central ID:
  PMC7454066
• Document Type:
  Journal Article
• Place as Subject:
  Hong Kong
• Volume:
  26
• Issue:
  9
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:bc9ac2a2d51cec5dc71ec693439180b155747552613cab4c19f697fe5340bbca
• Download URL:
  https://stacks.cdc.gov/view/cdc/92989/cdc_92989_DS1.pdf
• File Type:
  [PDF - 1.36 MB ]