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Epidemiologic Investigation of Burkholderia cepacia Acquisition in Two Pediatric Intensive Care Units

Published online by Cambridge University Press:  02 January 2015

Chawki Loukil ,
Carole Saizou ,
Catherine Doit ,
Philippe Bidet ,
Patricia Mariani-Kurkdjian ,
Yannick Aujard ,
François Beaufils  and
Edouard Bingen
Chawki Loukil
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Carole Saizou
Affiliation:
Department of Pediatric Intensive Care, Hôpital Robert Debré, Paris, France
Catherine Doit
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Philippe Bidet
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Patricia Mariani-Kurkdjian
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
Yannick Aujard
Affiliation:
Department of Neonatology, Hôpital Robert Debré, Paris, France
François Beaufils
Affiliation:
Department of Pediatric Intensive Care, Hôpital Robert Debré, Paris, France
Edouard Bingen*
Affiliation:
Department of Microbiology, Hôpital Robert Debré, Paris, France
*
Department of Microbiology, Hôpital Robert Debré, 48, Boulevard Serurier, 75019 Paris, France
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Abstract

Objectives:

To investigate and describe an outbreak of Burkholderia cepacia in a neonatal intensive care unit (NICU) and a pediatric intensive care unit (PICU), and to report the interventions leading to the cessation of the outbreak.

Design:

We conducted an epidemiologic investigation of an outbreak of B. cepacia colonization or infection in two clinical wards during a 35-month period (December 1998 to October 2001).

Setting:

A 500-bed, university hospital-affiliated, tertiary-care pediatric institution in Paris, France, with a 22-bed PICU and 31-bed NICU.

Methods:

Ribotyping was used to determine the genotypes of B. cepacia isolates. Procedures for the maintenance and disinfection of respiratory therapy devices were reviewed.

Results:

Thirty-two children were colonized (n = 14) or infected (n = 18) by B. cepacia in 2 wards (28 in the PICU and 4 in the NICU). In the PICU, a single ribotype was found among the isolates obtained from all of the patients except 1, and from the 6 isolates obtained from respiratory therapy devices (ie, heated humidifier water). In the NICU, the isolates obtained from the patients harbored a single ribotype unrelated to that of the epidemic strain isolated in the PICU; no environmental source of infection was found.

Conclusion:

Two different outbreaks appeared to be associated with 2 ribotypes, 1 of which was linked to patient-to-patient transmission via respiratory therapy devices. Complete elimination of the outbreak was achieved only when disposable, sterilizable, or easy-to-disinfect materials were used in the PICU. The source of infection in the NICU was not found.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 9 , September 2003 , pp. 707 - 710
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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