1173. Molecular and Epidemiological Investigation of a Pseudo-Outbreak by Burkholderia cepacia in two Intensive Care Units in a University Hospital in Bogotá, Colombia
Session: Poster Abstract Session: Public Health
Friday, October 9, 2015
Room: Poster Hall
Posters
  • Poster B. cepacia.jpg (803.4 kB)
  • Background: The Burkholderia cepacia has been described as an outbreaks-causing agent, in which case frequently corresponds to environmental sources.

    Methods:  In Bogotá, Colombia, 3 patients were identified with B. cepacia bacteremia with in-hospital stay of less than 48 hours in the adult Intensive Care Unit (ICU). It was suspected an outbreak or a pseudo-outbreak taking into account the institutional epidemiologic curve. As a starting measure, the management ICU batches for the patients were changed and environmental cultures were taken. A review of the literature was made, searching for this kind of B. cepacia-associated outbreaks. Samples in sterile solutions were sent to the laboratory for microbiologic study. The B. cepacia isolation samples were sent for molecular analysis.

    Results: 8 patients with positive blood cultures for B. cepacia were identified in the adults ICU and in the pediatric ICU, with ages between 3 months to 88 years, 5 patients were women (63%) and 3 men (37%). In 100% of cases the blood cultures were taken through a central venous catheter. None of the patients presented clinical manifestations of infection by this microorganism. It was documented a positive growing culture of B. cepacia in a Chlorhexidine sachet soap batch and in samples from the washbasin that was correlated with the clone identified in the patients. The withdraw of the Chlorhexidine sachet soap batch plus the optimization of cleaning and disinfection processes, hand washing and isolation measures, were effective to accomplished the control of the pseudo-outbreak, without presenting infection associated cases.

    Conclusion: One pseudo-outbreak was documented by B. cepacia, affecting the adult UCI as well as the pediatric ICU caused by the contamination of a Chlorhexidine sachet soap batch and the washbasins. The active epidemiologic surveillance, with support from the microbiological laboratory for the early detection of outbreaks and pseudo outbreaks, enabled the start of measurements to avoid undesirable consequences for patients.

    Sandra Valderrama, Specialist in Infectious Diseases1, Sandra Gualtero, MD2, Yazmin Rodriguez, MD3, Claudia Janneth Linares Miranda, NP4, Ángela Patricia Gonzalez, Nurse of the infectious diseases control group1 and Marley Andrea Ávila, Epidemiologist5, (1)Hospital Universitario San Ignacio, Bogotá, Colombia, (2)Hospital Universitario San Ignacio, Bogota, Colombia, (3)Infectious Diseases, Hospital Universitario San Ignacio, Bogotá, Colombia, (4)Infectious Diseases, Hospital Universitario San Ignacio, BOGOTA, Colombia, (5)Instituto Nacional de Salud, Bogotá, Colombia

    Disclosures:

    S. Valderrama, None

    S. Gualtero, None

    Y. Rodriguez, None

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