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"The aim of this study was to better depict the outbreak of healthcare-associated bacteremia caused by Burkholderia gladioli due to contaminated multi-dose vials with saline solutions" Dobrović et al (2022).
Multi-dose vial contamination

Abstract:

Objectives: Burkholderia gladioli has been associated with infections in patients with cystic fibrosis, chronic granulomatous disease and other immunocompromising conditions. The aim of this study was to better depict the outbreak of healthcare-associated bacteremia caused by Burkholderia gladioli due to contaminated multi-dose vials with saline solutions.

Methods: An environmental and epidemiological investigation was conducted by the Infection Prevention and Control Team (IPCT) in order to identify the source of the outbreak in three Croatian hospitals.

Results: During a three-month period, a total of thirteen B. gladioli bacteremia episodes were identified in ten patients in three Croatian hospitals. At the time of the outbreak, all three hospitals used saline products from the same manufacturer. Two 100 ml multi-dose vials with saline solutions and needleless dispensing pins were B. gladioli positive. All thirteen bacteremia isolates, as well as two isolates from the saline, showed the same antimicrobial susceptibility patterns and pulsed-field gel electrophoresis profile demonstrating clonal relatedness.

Conclusions: When an environmental pathogen causes an outbreak, contamination of intravenous products must be considered. Close communication between local IPCT and the National Hospital Infection Control Advisory Committee is essential to conduct a prompt and thorough investigation and find the source of the outbreak.

Reference:

Dobrović K, Mareković I, Payerl-Pal M, Andrijašević N, Škrobo T, Koščak V, Grgurić D, Crnek SŠ, Janeš A, Lukić-Grlić A, Selec K, Bukovski S, Čivljak R. Outbreak of healthcare-associated bacteremia caused by Burkholderia gladioli due to contaminated multi-dose vials with saline solutions in three Croatian hospitals. Int J Infect Dis. 2022 May 10:S1201-9712(22)00274-0. doi: 10.1016/j.ijid.2022.05.012. Epub ahead of print. PMID: 35562041.